Displacement of the Retina and Its Recovery After Vitrectomy in Idiopathic Epiretinal Membrane

Objective: To study the displacement of the retina and its change after vitrectomy in idiopathic epiretinal membrane (ERM).

Design: Prospective, interventional case series.

Methods: Fifty-six eyes of 53 consecutive patients with ERM underwent vitrectomy with ERM removal and internal limiting membrane peeling. Fundus autofluorescence (FAF) imaging was examined before and at 1, 3, 6, and 12 months after vitrectomy. Main outcome measures were the proportion of eyes with retinal displacement for ERM detected by FAF imaging and the recovery rate of retinal displacement after vitrectomy.

Results: Before surgery, FAF photography demonstrated hyperautofluorescent lines within the vascular arcade in 37 (66.1%) of the 56 eyes. The lines seemed to be consistent with the location of the retinal vessels before their displacement. These hyperautofluorescent lines appeared significantly more frequently among patients in whom the disease duration was 3 years or less. In 23 (62.2%) of these 37 eyes, within the first postoperative month, the hyperautofluorescent lines disappeared. The disappearance of the hyperautofluorescent line was thought to be the result of the return of the retinal vessel to its original position. Greater visual improvements (logarithm of the minimal angle of resolution, ≥0.3) were statistically significantly obtained in patients in whom the hyperautofluorescent lines had become indistinct at 1 month after surgery (P < .05).

Conclusions: Hyperautofluorescent lines indicating retinal displacement were found by FAF in 66.1% of patients before surgery for ERM. In addition, retinal displacement was significantly more common among patients who had experienced subjective symptoms for 3 years or less. Fundus autofluorescence is useful for predicting postoperative visual acuity improvement.