title: Deep and superficial OCT angiography changes after macular peeling: idiopathic vs diabetic epiretinal membranes.
abstract: BACKGROUND
  To assess changes in deep and superficial perifoveal capillary plexus after macular peeling in idiopathic and diabetic epiretinal membrane (iERM and dERM, respectively).
  
  
  METHODS
  Cross-sectional comparative study. We included 40 eyes from 40 patients affected by iERM (20 eyes) and dERM (20 eyes), as well as 34 eyes from 17 healthy, age-matched patients. Patients received a complete ophthalmic evaluation including axial and en-face scanning spectral-domain analysis, optical coherence tomography angiography, and microperimetry. Split-spectrum amplitude-decorrelation angiography images were obtained to quantify the deep and superficial layers of perifoveal capillary-free zone (CFZ). The main outcome measures were: (i) differences at baseline between deep and superficial CFZ in iERM and dERM vs control, and (ii) changes in deep and superficial CFZ plexus after surgery in iERM vs dERM.
  
  
  RESULTS
  The deep CFZ only significantly increased in dERM at the end of the follow-up period (6 months). No statistically significant differences were found between preoperative and postoperative superficial vascular plexus in iERM or dERM. At the end of the follow-up, statistically significant differences between preoperative and postoperative ganglion cell complex (GCC) average were found only in the iERM group. Best-corrected visual acuity significantly improved after surgery both in the iERM (P = 0.0053) and dERM (P < 0.0001) groups. After 6 months, macular sensitivity increased in the iERM group, but there was no statistically significant change in the dERM group.
  
  
  CONCLUSIONS
  In dERM, the deep CFZ significantly increases after ILM peeling, whereas postoperative angiography changes were not significant in iERM. This could be because the impaired diabetic perifoveal capillary plexus are more sensitive to the iatrogenic damage to Müller cells, induced by peeling.
authors.affiliation: Department of Biomedical Sciences, Humanitas University, Via Manzoni 113, Rozzano - Milan, 20089, Italy. mario.romano.md@gmail.com.|Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Via Pansini 5, 80131, Naples, Italy. mario.romano.md@gmail.com.
authors.forename: Mario R
authors.initials: MR
authors.lastname: Romano
authors.affiliation: Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Via Pansini 5, 80131, Naples, Italy.
authors.forename: Gilda
authors.initials: G
authors.lastname: Cennamo
authors.affiliation: Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Via Pansini 5, 80131, Naples, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Schiemer
authors.affiliation: Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Via Pansini 5, 80131, Naples, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Rossi
authors.affiliation: Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Via Pansini 5, 80131, Naples, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Sparnelli
authors.affiliation: Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Via Pansini 5, 80131, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cennamo
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology*; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D011184:Postoperative Period; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
keywords: Deep perifoveal capillary network; Epiretinal membrane; Optical coherence tomography angiography; Split-spectrum amplitude-decorrelation angiography; Superficial perifoveal capillary plexus