Novel Optical Coherence Tomography Parameters as Prognostic Factors for Stage 3 Epiretinal Membranes

Abstract

Purpose. We aimed to describe the visual prognosis of eyes with ectopic inner foveal layers (EIFLs) after epiretinal membrane (ERM) surgery. Methods. This retrospective study enrolled patients diagnosed with stage 3 ERM based on the EIFL staging scheme who underwent ERM surgery with a minimum follow-up period of 12 months. Central foveal thickness (CFT), EIFL thickness, and the length of the ellipsoid zone defect were evaluated at baseline and at 1 month, 6 months, and 12 months after surgery based on pre- and postoperative swept-source optical coherence tomography (OCT) images. The association of EIFL thickness and other OCT parameters with pre- and postoperative best-corrected visual acuity (BCVA) was analyzed. Results. Sixty-nine eyes with stage 3 ERMs were analyzed. Preoperative BCVA was correlated with preoperative CFT (r = 0.517, p<0.001) and preoperative EIFL thickness (r = 0.652, p<0.001). At 12 months, postoperative BCVA was correlated negatively with preoperative CFT (r = 0.470, p=0.016) and preoperative EIFL thickness (r = 0.582, p=0.004). The improvement in BCVA was not associated with postoperative reduction in CFT p=0.06, although it was significantly associated with postoperative reduction in EIFL thickness (r = 0.635, p=0.007). Conclusions. EIFL thickness should be considered a negative prognostic factor for postoperative anatomical and functional recovery in patients with stage 3 ERMs.