Retinal Surface En Face Optical Coherence Tomography: a New Imaging Approach in Epiretinal Membrane Surgery

Purpose: To describe the clinical effectiveness of a new imaging approach: en face spectral domain optical coherence tomography of the retinal surface before and after epiretinal membrane (ERM) and internal limiting membrane peeling.

Methods: Retrospective analysis of preoperative and postoperative en face spectral domain optical coherence tomography images of the inner face of the macula obtained from 20 eyes of 20 patients undergoing vitrectomy with internal limiting membrane peeling for ERM.

Results: Preoperatively, en face spectral domain optical coherence tomography imaging of the retinal surface clearly showed plaques surrounded by radiating folds because of ERM. It could also disclose areas possibly devoid of internal limiting membrane secondary to ERM contraction. A rough retinal surface was visible in the peeled area during the first postoperative month. At 3 months, various amounts of dimples were progressively observed in 13 of 15 eyes (87%). In all these cases, they lasted or increased in size and number at the last follow-up examination. Some residual epiretinal tissue was also detected by this technique.

Conclusion: En face spectral domain optical coherence tomography of the retinal surface is an interesting complement to standard retinal optical coherence tomography section that provides an easy-to-understand global overview of the retinal surface. It can detect and classify tiny progressive morphologic changes in the texture of the retinal surface occurring after internal limiting membrane peeling.