Mayer, Wolfgang J.; Vogel, Michaela; Neubauer, Aljoscha; Kernt, Marcus; Kampik, Anselm; Wolf, Armin; Haritoglou, Christos (2013): Pars Plana Vitrectomy and Internal Limiting Membrane Peeling in Epimacular Membranes: Correlation of Function and Morphology across the Macula. In: Ophtalmologica, Nr. 1: S. 9-17




Purpose: To analyze the correlation between morphological and functionalresults 12 months after epiretinal membrane (ERM) surgery. Methods: 31eyes from 31 consecutive patients with nnetamorphopsia and bestcorrected visual acuity (BCVA) below 20/32 underwent a transconjunctival23-gauge vitrectomy with ERM and internal limiting membrane peeling. Preoperatively and 3, 6 and 12 months postoperatively, we assessed BCVA,microperimetry (MP-1) and spectral domain optical coherence tomography(SD-OCT). Photoreceptor inner and outer segment (IS/OS) was graded onSD-OCT images and correlated with microperimetry measurements in thefovea and parafoveal region. Results: The postoperative BCVA wassignificantly better in eyes with an intact IS/OS junction (p < 0.01).In addition, the mean defect depth was postoperatively decreased in thefoveal and parafoveal area in eyes with an intact IS/OS junction. Acorrelation of SD-OCT IS/OS images and microperinnetry in eyes withimprovement in BCVA of at least 2 lines revealed a statisticallysignificant result for the parafoveal quadrants (p < 0.011 for SD-OCTand p < 0.005 for microperimetry) but not for the foveal area alone.Conclusions: The IS/OS regeneration in the parafoveal quadrantscontributes significantly to the recovery of BCVA following ERM surgery.Consequently, functional and morphological tests of the macular areashould not be limited to the fovea but should be extended to theparafoveal region.