LONG-TERM RETROSPECTIVE ANALYSIS OF VISUAL ACUITY AND OPTICAL COHERENCE TOPOGRAPHIC CHANGES AFTER SINGLE VERSUS DOUBLE PEELING DURING VITRECTOMY FOR MACULAR EPIRETINAL MEMBRANES. Issue 11 (November 2016)

• Record Type: Journal Article
• Authors: Jung, Jesse J.; Hoang, Quan V.; Ridley-Lane, Megan L.; Sebrow, Dov B.; Dhrami-Gavazi, Elona; Chang, Stanley
• Is Part Of: Retina. Volume 36:Issue 11(2016:Nov.)
• Publication Date: 2016-11
• Subjects: brilliant blue G -- dimpling of nerve fiber layer -- epiretinal membrane -- inner retinal dimpling -- internal limiting membrane -- optical coherence tomography -- membrane peeling -- vitrectomy; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000001055
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To determine the long-term effect of internal limiting membrane with associated epiretinal membrane (ERM) peeling versus single peeling alone in terms of best-corrected visual acuity and anatomical outcomes on spectral-domain optical coherence tomography. Methods: This retrospective comparative cohort study of patients who had follow-up of >1 year and underwent surgery for ERM by a single surgeon (S.C.) from January 1, 2008 to December 31, 2012 compared cases in which the internal limiting membrane was stained with brilliant blue G to facilitate double peeling (n = 42) and single peeling (n = 43) of the ERM alone for up to 3 years of follow-up. For continuous variables, an independent two-tailed t -test was performed. For binary variables, the Fisher's exact test was performed. Statistical significance was defined as P < 0.05. Results: Eighty-five of 142 patients fit the inclusion criteria. At the last follow-up, the single-peeling group were more likely to have ERM remaining in the central fovea postoperatively ( P = 0.0020, becoming significant by postoperative Year 1, P = 0.022) and less likely to develop inner retinal dimpling ( P = 0.000, becoming significant by postoperative Month 3, P = 0.015). At 3 years, central foveal thickness had decreased in the single-peeling group by −136.9 µm and by −84.1 μ m in the double-peeling group, which was not significantly different ( P = 0.08). Mean best-corrected visual acuity improved in both the groups at all time points. There was no statistically significant difference between the 2 groups at 3 years ( P = 0.44; single-peeling group, 0.32 ± 0.42, Snellen 20/42; double-peeling group, 0.23 ± 0.27, Snellen 20/34). Conclusion: Brilliant blue G–assisted internal limiting membrane peeling for ERM results in a more thorough removal of residual ERM around the paracentral fovea. However, there is no difference in long-term best-corrected visual acuity at 3 years and a greater likelihood of inner retinal dimpling. Abstract : Brilliant blue G–assisted internal limiting membrane, "double peeling, " for idiopathic macular pucker results in less residual epiretinal membrane in the parafovea compared with "single peeling" of only the epiretinal membrane. Although there is no significant difference in the final best-correct visual acuity at 2 years and 3 years, double-peeling results in a greater likelihood of inner retinal dimpling of the nerve fiber layer observed on spectral-domain optical coherence tomography.