Diagnostic Reliability of Optical Coherence Tomography Biomarkers for Postsurgical Success in Visual Acuity in Patients with Idiopathic Epiretinal Membranes

Abstract

Introduction Several optical coherence tomography (OCT) biomarkers for postsurgical success in patients with idiopathic epiretinal membranes (iERMs) have been described in single predictor analyses. The aim of this study was to assess the reliability of diagnosis of OCT biomarkers and to calculate their impact on postsurgical visual acuity by applying multiple regression analysis.

Methods This retrospective study included patients scheduled for pars plana vitrectomy with membrane peeling for iERMs. Presurgical OCT scans were analyzed for the presence of OCT biomarkers by two reviewers. Intra- and interobserver reliability was calculated with the Kuder-Richardson 20 test.

Results Among the 136 patients included, intra-/interobserver reliability of the OCT biomarkers was 0.89/0.70 for ectopic inner foveal layer (EIFL), 0.82/0.53 for disorganization of retinal inner layer (DRIL), 0.93/0.89 for intraretinal cystoid changes, 0.84/0.78 for alterations of the ellipsoid zone, 0.84/0.72 for cotton ball sign, 0.68/0.58 for hyperreflective foci, 0.55/0.47 for epimacular membrane rips (EMM-rips), and 0.87/0.60 for retinal contraction. Only DRIL and central subfield macular thickness (CMT) were significant predictors for BCVA 3 months after surgery in a multiple regression analysis.

Conclusion Intraobserver reliability of OCT biomarkers was higher than interobserver reliability, reflecting both clinical and grading experience with respect to OCT biomarker evaluation. DRIL and CMT were shown to be significant predictors in a multiple regression analysis, with potential for negative influence on final BCVA after vitrectomy with membrane peeling for iERMs.

Key words

vitrectomy with membrane peeling - OCT biomarker - epiretinal membrane

Publikationsverlauf

Eingereicht: 26. Dezember 2021

Angenommen: 25. Januar 2022

Artikel online veröffentlicht:
14. April 2022

• References/Literatur

• 1 Mitchell P, Smith W, Chey T. et al. Prevalence and associations of epiretinal membranes. The Blue Mountains Eye Study, Australia. Ophthalmology 1997; 104: 1033-1040
• 2 Bu SC, Kuijer R, Li XR. et al. Idiopathic epiretinal membrane. Retina 2014; 34: 2317-2335
• 3 Kohno RI, Hata Y, Kawahara S. et al. Possible contribution of hyalocytes to idiopathic epiretinal membrane formation and its contraction. Br J Ophthalmol 2009; 93: 1020-1026
• 4 Zhao F, Gandorfer A, Haritoglou C. et al. Epiretinal cell proliferation in macular pucker and vitreomacular traction syndrome: analysis of flat-mounted internal limiting membrane specimens. Retina 2013; 33: 77-88
• 5 Sebag J. Anatomy and pathology of the vitreo-retinal interface. Eye (Lond) 1992; 6: 541-552
• 6 Guidry C. The role of Müller cells in fibrocontractive retinal disorders. Prog Retin Eye Res 2005; 24: 75-86
• 7 Vinores SA, Campochiaro PA, McGehee R. et al. Ultrastructural and immunocytochemical changes in retinal pigment epithelium, retinal glia, and fibroblasts in vitreous culture. Invest Ophthalmol Vis Sci 1990; 31: 2529-2545
• 8 Sheales MP, Kingston ZS, Essex RW. Associations between preoperative OCT parameters and visual outcome 3 months postoperatively in patients undergoing vitrectomy for idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2016; 254: 1909-1917
• 9 Leisser C, Hirnschall N, Hackl C. et al. Risk factors for postoperative intraretinal cystoid changes after peeling of idiopathic epiretinal membranes among patients randomized for balanced salt solution and air-tamponade. Acta Ophthalmol 2018; 96: e439-e444
• 10 Leisser C, Hirnschall N, Döller B. et al. Effect of Air Tamponade on Postoperative Visual Acuity and Intraretinal Cystoid Changes after Peeling of Idiopathic Epiretinal Membranes in Pseudophakic Patients. Ophthalmologica 2020; 243: 37-42
• 11 Leisser C, Hirnschall N, Findl O. Effect of Phacoemulsification on Outcomes after Vitrectomy with Membrane Peeling regarding New Intraretinal Cystoid Changes and Transient Macular Edema. Ophthalmologica 2021; 244: 150-158
• 12 Mitamura Y, Hirano K, Baba T. et al. Correlation of visual recovery with presence of photoreceptor inner/outer segment junction in optical coherence images after epiretinal membrane surgery. Br J Ophthalmol 2009; 93: 171-175
• 13 Suh MH, Seo JM, Park KH. et al. Associations between macular findings by optical coherence tomography and visual outcomes after epiretinal membrane removal. Am J Ophthalmol 2009; 147: 473-480
• 14 Oster SF, Mojana F, Brar M. et al. Disruption of the photoreceptor inner segment/outer segment layer on spectral domain-optical coherence tomography is a predictor of poor visual acuity in patients with epiretinal membranes. Retina 2010; 30: 713-718
• 15 Inoue M, Morita S, Watanabe Y. et al. Preoperative inner segment/outer segment junction in spectral-domain optical coherence tomography as a prognostic factor in epiretinal membrane surgery. Retina 2011; 31: 1366-1372
• 16 Shimozono M, Oishi A, Hata M. et al. The significance of cone outer segment tips as a prognostic factor in epiretinal membrane surgery. Am J Ophthalmol 2012; 153: 698-704
• 17 Watanabe K, Tsunoda K, Mizuno Y. et al. Outer retinal morphology and visual function in patients with idiopathic epiretinal membrane. JAMA Ophthalmol 2013; 131: 172-177
• 18 Cobos E, Arias L, Ruiz-Moreno J. et al. Preoperative study of the inner segment/outer segment junction of photoreceptors by spectral-domain optical coherence tomography as a prognostic factor in patients with epiretinal membranes. Clin Ophthalmol 2013; 7: 1467-1470
• 19 Govetto A, Virgili G, Rodriguez FJ. et al. Functional and anatomical significance of the ectopic inner foveal layers in eyes with idiopathic epiretinal membranes: Surgical Results at 12 Months. Retina 2019; 39: 347-357
• 20 Tsunoda K, Watanabe K, Akiyama K. et al. Highly reflective foveal region in optical coherence tomography in eyes with vitreomacular traction or epiretinal membrane. Ophthalmology 2012; 119: 581-587
• 21 Sigler EJ, Randolph JC, Calzada JI. Incidence, morphology, and classification of epimacular membrane rip. Retina 2013; 33: 1158-1165
• 22 Zur D, Iglicki M, Feldinger L. et al. Disorganization of Retinal Inner Layers as a Biomarker for Idiopathic Epiretinal Membrane After Macular Surgery-The DREAM Study. Am J Ophthalmol 2018; 196: 129-135
• 23 Karasavvidou EM, Panos GD, Koronis S. et al. Optical coherence tomography biomarkers for visual acuity in patients with idiopathic epiretinal membrane. Eur J Ophthalmol 2021; 31: 3203-3213
• 24 Leisser C, Hirnschall N, Findl O. Effect of Air Tamponade on Tilt of the Intraocular Lens after Phacovitrectomy. Ophthalmologica 2019; 242: 118-122
• 25 Leisser C, Paschalis E, Rokidi S. et al. Fourier-Transform Infrared Spectroscopy of Epiretinal Membranes and Internal Limiting Membranes after Pars Plana Vitrectomy with Membrane Peeling. Ophthalmic Res 2021; 64: 793-797
• 26 Leisser C, Hirnschall N, Palkovits S. et al. Intraoperative Optical Coherence Tomography-Guided Membrane Peeling for Surgery of Macular Pucker: Advantages and Limitations. Ophthalmologica 2019; 241: 234-240
• 27 Leisser C, Stimpfl T, Ruiss M. et al. Caffeine uptake into the vitreous after peroral coffee consumption. Ophthalmic Res 2020; 63: 533-540
• 28 Leisser C, Ruiss M, Pilwachs C. et al. Effect of Air Tamponade among Patients with Epiretinal Membranes and Intraretinal Cystoid Changes Undergoing Vitrectomy with Membrane Peeling – A Prospective Randomized Trial. Klin Monbl Augenheilkd 2021;
• 29 Silva N, Ferreira A, Marques JH. et al. Epiretinal membrane vitrectomy: outcomes with or without cataract surgery and a novel prognostic factor for cystoid macular edema. Graefes Arch Clin Exp Ophthalmol 2021; 259: 1731-1740