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Chou HD, Chang YC, Wu PY, Kang EYC, Chen YH, Liu L, Chen KJ, Hwang YS, Chao AN, Wu WC, Lai CC. Retinal vascular arcade angle as a biomarker for visual improvement after epiretinal membrane surgery. Eye (Lond) 2024; 38:778-785. [PMID: 37865724 PMCID: PMC10920802 DOI: 10.1038/s41433-023-02776-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/23/2023] Open
Abstract
OBJECTIVES To investigate the changes in the temporal vascular angles after epiretinal membrane (ERM) surgery and utilize the angles to predict visual outcomes. METHODS A total of 168 eyes from 84 patients with unilateral ERM who underwent vitrectomy were enrolled from a single institution. The angles of temporal venous (anglevein) and arterial arcades (angleartery) were measured on fundus photographs. The relationships between the angles and the best-corrected visual acuity (BCVA) were explored and multivariable logistic models and receiver operating characteristic (ROC) curves were analyzed to identify the factors that predicted visual outcomes. RESULTS At baseline, both angleartery and anglevein were narrower in the eyes with ERM than the fellow eyes (p < 0.001 and 0.007) but had no correlation with the baseline BCVA (p = 0.754 and 0.804). Postoperatively, the angleartery and anglevein significantly widened (both p < 0.001) and a greater BCVA improvement was associated with a greater widening of the angleartery (p = 0.029) and anglevein (p = 0.050). Multivariable logistic analyses found a narrower baseline angleartery compared to the fellow eye had a higher chance for BCVA improvement ≧ 2 lines (Odds ratio = 0.97; 95% CI, 0.94-0.99; p = 0.016). ROC curve showed the baseline difference in the angleartery between bilateral eyes predicted BCVA improvement ≧ 2 lines (area under the curve = 0.74; p = 0.035), and a 0.73 sensitivity and 0.80 specificity with a cut-off value of -27.19 degrees. CONCLUSIONS The retinal vascular angles widened after ERM surgery and the fundus photograph-derived angles may serve as a highly-accessible biomarker to predict postoperative visual outcomes.
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Affiliation(s)
- Hung-Da Chou
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Chieh Chang
- Department of Medical Education, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Po-Yi Wu
- Department of Medical Education, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Eugene Yu-Chuan Kang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsing Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Laura Liu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Jen Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yih-Shiou Hwang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - An-Ning Chao
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Chun Lai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.
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Takeyama A, Imamura Y, Fujimoto T, Iida T, Komiya Y, Ishida M. Aniseikonia and retinal morphological changes in eyes undergoing macular hole surgery. Sci Rep 2024; 14:59. [PMID: 38168792 PMCID: PMC10762157 DOI: 10.1038/s41598-023-51032-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/29/2023] [Indexed: 01/05/2024] Open
Abstract
Even after idiopathic macular hole (MH) surgery and with successful closure of MH, aniseikonia is a common postoperative symptom. We investigated the correlation of MH diameter, retinal displacement and retinal layer thicknesses with aniseikonia in 41 eyes of 41 patients undergoing MH surgery with internal limiting membrane peeling. Aniseikonia was measured with the New Aniseikonia Test. Retinal displacement (RD%) was defined as change of retinal distance between the temporal margin of the optic papilla and the intersection of the retinal vessels. Changes of thicknesses of the inner nuclear layer (INL%) and the outer retinal layer (OR%) were calculated. Aniseikonia improved postoperatively. Preoperative aniseikonia and their improvement at 6 months correlated with MH diameters (P = 0.004-0.046). Improvement of aniseikonia correlated with temporal RD% (P = 0.002-0.012). Improvement of vertical aniseikonia correlated with INL% at 2 weeks and with the nasal OR% at 1, 3, and 6 months (P = < 0.001-0.028). MH diameter and age were significant predictors for improvement of aniseikonia. The greater the temporal retina displacement, and the thinner the postoperative INL and OR, the greater the improvement of aniseikonia. MH diameter and age are strong predictors for improvement of aniseikonia after MH surgery.
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Affiliation(s)
- Asuka Takeyama
- Department of Ophthalmology, Toho University Ohashi Medical Center, 2-22-36, Ohashi, Meguro-ku, Tokyo, 153-8515, Japan.
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan.
| | - Yutaka Imamura
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan
| | - Taichi Fujimoto
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan
| | - Toshiya Iida
- Department of Ophthalmology, Toho University Ohashi Medical Center, 2-22-36, Ohashi, Meguro-ku, Tokyo, 153-8515, Japan
| | - Yuko Komiya
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan
| | - Masahiro Ishida
- Department of Ophthalmology, Toho University Ohashi Medical Center, 2-22-36, Ohashi, Meguro-ku, Tokyo, 153-8515, Japan
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan
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Güvenç U, Üney G, Ünlü N, Acar MA, Hazırolan D, Candan Ö. Epiretinal membrane related vascular changes in diabetic eyes evaluated with optical coherence tomography angiography. Int J Ophthalmol 2023; 16:1503-1511. [PMID: 37724284 PMCID: PMC10475617 DOI: 10.18240/ijo.2023.09.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 07/03/2023] [Indexed: 09/20/2023] Open
Abstract
AIM To evaluate the retinochoroidal microvascular circulation and anatomical structure of diabetic and non-diabetic patients with epiretinal membrane (ERM) with the help of optical coherence tomography angiography (OCT-A) and compare them with healthy control subjects. METHODS In this prospective, cross-sectional study, a total of 165 eyes were evaluated, including 50 eyes of patients with diabetic ERM, 54 eyes of idiopathic ERM (iERM) patients, and 61 eyes of healthy controls. Macula and disc angiography was performed by OCT-A. Macular vessel density (VD) ratio was evaluated by dividing the VD of the foveal region by the VD of the parafoveal region. Statistical calculations were evaluated at the 95% confidence interval. RESULTS Macula superficial VD values of ERM cases were lower than that in the control group, while foveal VD was higher in ERM cases. Macula deep VD values of ERM cases were lower in all quadrants, except the fovea. The width of the foveal avascular zone (FAZ) area was significantly lower in the ERM groups, and the FAZ width was lowest in iERM group. Macula superficial VD ratio was significantly higher in the ERM groups, but there was no significant difference between ERM groups. Macula deep VD ratio was significantly higher in the iERM group than in the control group. CONCLUSION Diabetic and idiopathic ERMs differ in their mechanism of formation and clinical presentation, as well as their effect on retinal vascular structures. If the relationship of increase of retinal thickness with vascular integrity can be demonstrated with OCT-A, then, OCT-A can be used as a guide for ERM prognosis.
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Affiliation(s)
- Umay Güvenç
- Ankara Training and Research Hospital Ophthalmology Department, Ankara 06800, Türkiye
| | - Güner Üney
- Ankara Training and Research Hospital Ophthalmology Department, Ankara 06800, Türkiye
| | - Nurten Ünlü
- Ankara Training and Research Hospital Ophthalmology Department, Ankara 06800, Türkiye
| | - Mehmet Akif Acar
- Ankara Training and Research Hospital Ophthalmology Department, Ankara 06800, Türkiye
| | - Dicle Hazırolan
- Ankara Training and Research Hospital Ophthalmology Department, Ankara 06800, Türkiye
| | - Özlem Candan
- Ankara Training and Research Hospital Ophthalmology Department, Ankara 06800, Türkiye
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