title: Vitreopapillary traction in eyes with idiopathic epiretinal membrane: a spectral-domain optical coherence tomography study.
abstract: OBJECTIVE
  To investigate the prevalence of vitreopapillary traction (VPT) and its effect on peripapillary structure and visual function in eyes with idiopathic epiretinal membrane (ERM).
  
  
  METHODS
  Observational, comparative study.
  
  
  METHODS
  Patients with idiopathic ERM (n = 116 eyes) and controls with similar age (n = 62 eyes).
  
  
  METHODS
  Spectral domain optical coherence tomography (SD-OCT) axial optic disc scans were evaluated to identify VPT in eyes with idiopathic ERM. Based on VPT presence/absence, eyes were categorized as ERM with VPT (ERM+VPT, n = 52 eyes) or ERM without VPT (ERM-VPT, n = 64 eyes). Optic nerve head (ONH) parameters, average and sectoral retinal nerve fiber layer (RNFL) thickness, and central macular thickness (CMT) were compared between groups. Best-corrected visual acuity (BCVA) and visual field (VF) (automated Humphrey central 30-2 perimetry) mean deviation (MD) and pattern standard deviation (PSD) were compared between groups.
  
  
  METHODS
  The ONH parameters, peripapillary RNFL thickness, BCVA, VF MD, and PSD.
  
  
  RESULTS
  Fifty-two of 116 eyes (44.8%) with idiopathic ERM had VPT. The ERM+VPT group had larger rim area, smaller average and vertical cup-to-disc ratios, and smaller cup volume than ERM-VPT and normal groups (all P < 0.001). Eyes with VPT had greater CMT than eyes without VPT (421.87±97.31 μm vs. 377.08±75.1 μm; P = 0.006). Average and temporal RNFL thickness was higher in ERM+VPT (98.64±9.33 μm and 93.90±23.42 μm) than in normal eyes (94.02±8.45 μm and 66.42±12.71 μm). No significant difference in BCVA was found between ERM-VPT and ERM+VPT eyes, but MD was lower in ERM+VPT than in ERM-VPT (-3.91±3.68 dB vs. -2.18±2.42 dB; P = 0.005). Additionally, PSD was greater in ERM+VPT. Multivariate logistic regression analysis revealed that age (odds ratio [OR], 1.190; P = 0.014) and increased CMT (OR, 1.013; P = 0.005) were associated with vision loss, whereas VPT presence was associated with VF defects (OR, 6.290; P = 0.024).
  
  
  CONCLUSIONS
  Vitreopapillary traction was observed in >40% of eyes with idiopathic ERM, as confirmed by SD-OCT imaging. Vitreopapillary traction with idiopathic ERM was associated with altered optic disc architecture, increased average and temporal RNFL thickness, and VF defects.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Yong Woo
authors.initials: YW
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Jeoung
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea. Electronic address: hgonyu@snu.ac.kr.
authors.forename: Hyeong Gon
authors.initials: HG
authors.lastname: Yu
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D019773:Epiretinal Membrane / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009901:Optic Nerve Diseases / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity; D014822:Vitreous Body / Q000473:pathology*