INTERNAL LIMITING MEMBRANE PEELING VERSUS NONPEELING TO PREVENT EPIRETINAL MEMBRANE DEVELOPMENT IN PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT: A Swept-Source Optical Coherence Tomography Study With a New Postoperative Classification System. Issue 7 (July 2020)

• Record Type: Journal Article
• Authors: Arias, Luis; Padrón-Pérez, Noel; Flores-Moreno, Ignacio; Giralt, Lena; Cobos, Estefanía; Lorenzo, Daniel; García-Bru, Pere; Dias, Bruno; Caminal, Josep M.
• Is Part Of: Retina. Volume 40:Issue 7(2020)
• Publication Date: 2020-07
• Subjects: epiretinal membrane -- internal limiting membrane peeling -- rhegmatogenous retinal detachment -- swept-source optical coherence tomography; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000002591
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To determine whether internal limiting membrane peeling in primary rhegmatogenous retinal detachment prevents epiretinal membrane (ERM) development. Secondarily, we propose a classification system for postoperative ERMs. Methods: Retrospective, interventional, comparative case series. Consecutive eyes with primary rhegmatogenous retinal detachment (n = 140) treated by a single surgeon. The presence of postoperative ERMs was assessed with swept-source optical coherence tomography. Results: An ERM was detected in 26 eyes (46.4%) in the nonpeeling group and in one eye (1.8%) in the internal limiting membrane peeling group ( P ⩽ 0.001). The median visual acuity significantly improved in both groups ( P ⩽ 0.001). Inner retinal dimples were observed in 41.1% of eyes in the internal limiting membrane peeling group versus 0% in the nonpeeling group ( P ⩽ 0.001), and they were not correlated with visual acuity (r = 0.011; P = 0.941). Based on swept-source optical coherence tomography findings, we identified three different types of ERMs: 7 (26.9%) were classified as Type 1, 12 (46.1%) as Type 2, and 7 (26.9%) as Type 3. Superficial retinal plexus deformations observed on optical coherence tomography angiography and en face images were detected in 100% of Type 3 ERMs, 41.6% of Type 2, and 0% of Type 1 (χ 2 = 14.3; P = 0.001). Interestingly, all of the patients who presented these alterations also had metamorphopsia. Conclusion: Internal limiting membrane peeling in primary rhegmatogenous retinal detachment seems to prevent postoperative ERM development. Swept-source optical coherence tomography analysis is helpful to define and classify different types of ERMs and to establish the surgical indication for their removal. Abstract : Internal limiting membrane peeling in primary rhegmatogenous retinal detachment is helpful to prevent postoperative epiretinal membrane development, and swept-source optical coherence tomography allows for defining three different types of epiretinal membranes.