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Analysing early changes of photoreceptor layer thickness following surgery in eyes with epiretinal membranes

Eye volume 38, pages 863–870 (2024)Cite this article

Subjects

Abstract

Background/Objectives

To analyse short-term changes of mean photoreceptor thickness (PRT) on the ETDRS-grid after vitrectomy and membrane peeling in patients with epiretinal membrane (ERM).

Subjects/Methods

Forty-eight patients with idiopathic ERM were included in this prospective study. Study examinations comprised best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) before surgery, 1 week (W1), 1 month (M1) and 3 months (M3) after surgery. Mean PRT was assessed using an automated algorithm and correlated with BCVA and central retinal thickness (CRT).

Results

Regarding PRT changes of the study eye in comparison to baseline values, a significant decrease at W1 in the 1 mm, 3 mm and 6 mm area (all p-values < 0.001), at M1 (p = 0.009) and M3 (p = 0.019) in the central 1 mm area, a significant increase at M3 in the 6 mm area (p < 0.001), but no significant change at M1 in the 3 mm and 6 mm area and M3 in the 3 mm area (all p-values > 0.05) were observed. BCVA increased significantly from baseline to M3 (0.3LogMAR-0.15LogMAR, Snellen equivalent = 20/40-20/28 respectively; p < 0.001). There was no correlation between baseline PRT and BCVA at any visit after surgery, nor between PRT and BCVA at any visit (all p-values > 0.05). Decrease in PRT in the 1 mm (p < 0.001), 3 mm (p = 0.013) and 6 mm (p = 0.034) area after one week correlated with the increase in CRT (449.9 µm–462.2 µm).

Conclusions

Although the photoreceptor layer is morphologically affected by ERMs and after their surgical removal, it is not correlated to BCVA. Thus, patients with photoreceptor layer alterations due to ERM may still benefit from surgery and achieve good functional rehabilitation thereafter.

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Fig. 1: Overview of the study design from patient inclusion to OCT-analysis.
Fig. 2: Photoreceptors of patients with different ERM stages before surgery, arranged in descending order (Stage 1 – upmost, Stage 2 – upper middle, Stage 3 – lower middle, Stage 4 – lowest).
Fig. 3: Correlation of the difference of mean photoreceptor thickness (PRT) in the 1 mm, 3 mm and 6 mm area and the difference of central retinal thickness (CRT) from baseline (BSL) to week 1 (W1).

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Data availability

Data are available from the authors upon reasonable request.

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Acknowledgements

We thank the team of the Vienna Clinical Trial Center (VTC) for their contribution.

Author information

Authors and Affiliations

  1. Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria

    Marlene Hollaus, Michael Georgopoulos, Johannes Iby, Oliver Leingang, Hrvoje Bogunovic, Ursula Schmidt-Erfurth & Stefan Sacu

  2. Vienna Clinical Trial Center, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria

    Marlene Hollaus, Johannes Iby & Stefan Sacu

  3. Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria

    Jonas Brugger

  4. Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria

    Oliver Leingang

  5. Christian Doppler Lab for Artificial Intelligence in Retina, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria

    Hrvoje Bogunovic

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Contributions

MH acquired and analysed patient data and wrote the original manuscript. MG provided input for the study design, performed surgery and interpreted patient data. JI acquired and analysed patient data. JB performed statistical analyses and contributed to writing the article. OL analysed and interpreted patient data. HB analysed patient data and provided his experience and knowledge for patient data interpretation. USE provided their input for the study design, reviewed and edited the manuscript. SS, the corresponding author of this article, designed the study, performed surgery, overviewed the conduction of the study, interpreted patient data, reviewed and edited the manuscript.

Corresponding author

Correspondence to Stefan Sacu.

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Competing interests

HB received research grants from Heidelberg Engineering and Apellis and speaker fees from Bayer, Roche, and Apellis. Stefan Sacu received funds from Bayer, Roche, Novartis, Iveric and Ionis. USE is a scientific consultant for Apellis, received grant support from Kodiak, Novartis, Apellis and RetInSight and received Patents/Royalty from RetInSight. JI, MH, MG, OL and JB report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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Hollaus, M., Georgopoulos, M., Iby, J. et al. Analysing early changes of photoreceptor layer thickness following surgery in eyes with epiretinal membranes. Eye 38, 863–870 (2024). https://doi.org/10.1038/s41433-023-02793-5

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