title: HIGH-RESOLUTION MULTIMODAL IMAGING AFTER IDIOPATHIC EPIRETINAL MEMBRANE SURGERY.
abstract: OBJECTIVE
  To investigate the changes of the vitreomacular interface during a 1-year follow-up after idiopathic epiretinal membrane (iERM) surgery.
  
  
  METHODS
  Six patients affected by fovea-attached iERM were recruited in this pilot study. Pars plana vitrectomy associated with epiretinal membrane peeling was performed uneventfully in all cases. In four cases, the inner limiting membrane was removed using Brilliant blue G. En face high-resolution adaptive optics and cross-sectional spectral domain optical coherence tomography retinal imaging were performed before and at 1, 3, 6, and 12 months after surgery. The microstructures of vitreomacular interface in high-resolution adaptive optics images were correlated to the cross-sectional spectral domain optical coherence tomography data.
  
  
  RESULTS
  Preoperatively, adaptive optics images showed multiple abnormalities of the vitreomacular interface, such as macrofolds, microfolds, and hyperreflective microstructures. We identified two subtypes of iERM according to the distribution of microfolds over the foveal area, which included the radial-type and the grid-type iERM. After surgery, the morphology of the vitreomacular interface changed compared with the preoperative state. The number of both macrofolds and microfolds was reduced in all cases. The hyperreflective structures were still resolvable in all cases, however presenting different shape and morphology than preoperatively. In addition, they showed marked differences between eyes that had internal limiting membrane removal and eyes that did not.
  
  
  CONCLUSIONS
  Adaptive optics imaging gives new insight into the changes of vitreomacular interface after iERM surgery. Enhanced multimodal imaging of the vitreomacular interface and retinal structures can be valuable to monitor treatment outcome of iERM.
authors.affiliation: *Fondazione G.B. Bietti IRCCS, Rome, Italy; †Department of Statistical Sciences, University of Rome "La Sapienza", Rome, Italy; ‡Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy; §Consiglio Nazionale delle Ricerche, Istituto di Processi Chimico-Fisici (CNR-IPCF), Messina, Italy; and ¶Vision Engineering Italy srl, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Lombardo
authors.forename: Fabio
authors.initials: F
authors.lastname: Scarinci
authors.forename: Daniela
authors.initials: D
authors.lastname: Giannini
authors.forename: Marco
authors.initials: M
authors.lastname: Pileri
authors.forename: Guido
authors.initials: G
authors.lastname: Ripandelli
authors.forename: Mario
authors.initials: M
authors.lastname: Stirpe
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lombardo
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Serrao
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D019773:Epiretinal Membrane / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D007202:Indicators and Reagents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010865:Pilot Projects; D011184:Postoperative Period; D057234:Preoperative Period; D012160:Retina / Q000473:pathology; D012394:Rosaniline Dyes / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014821:Vitrectomy; D014822:Vitreous Body / Q000473:pathology
chemical_list: D007202:Indicators and Reagents; D012394:Rosaniline Dyes; C004692:coomassie Brilliant Blue