title: Morphologic differences in epiretinal membranes on ocular coherence tomography as a predictive factor for surgical outcome.
abstract: OBJECTIVE
  To evaluate whether morphologic differences in idiopathic epiretinal membranes seen on optical coherence tomography may help predict surgical outcomes.
  
  
  METHODS
  Seventy-five eyes of 74 patients who underwent primary pars plana vitrectomy with membrane peeling were retrospectively reviewed. Outcome measures included visual acuity, macular contour on optical coherence tomography, central macular thickness, and reoperation rate.
  
  
  RESULTS
  According to the preoperative macular contour, 75 eyes were categorized into 4 types: 42 eyes were included in the diffuse (DIF) type, 12 in the cystoid macular edema (CME) type, 14 in the pseudolamellar hole (PLH) type, and 7 in the vitreomacular traction (VMT) type. Surgical procedure significantly improved vision in all types except for the PLH type (DIF, P < 0.0001; CME, P = 0.0378; PLH, P = 0.838; and VMT, P = 0.0273). There was a significant relationship between pre- and postoperative macular contour. All preoperative VMT showed normal contour on postoperative optical coherence tomography but had the highest reoperation rate.
  
  
  CONCLUSIONS
  Surgical intervention for the PLH-type epiretinal membrane was not associated with the visual improvement seen in other epiretinal membrane types, and the VMT type had the highest reoperation rate. Future studies should evaluate the potential benefit of internal limiting membrane peeling with or without short-term gas tamponade in these cases.
authors.affiliation: Division of Ophthalmology, Retina Service Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA.
authors.forename: Taiga
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Kyle D
authors.initials: KD
authors.lastname: Kovacs
authors.forename: Sushant
authors.initials: S
authors.lastname: Wagley
authors.forename: Jorge G
authors.initials: JG
authors.lastname: Arroyo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019773:Epiretinal Membrane / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D055815:Young Adult