![]() In a retrospective analysis of 16 eyes, the length of time of postoperative foveal thickness decrease was calculated to 109 days. Others describe improvement of visual acuity during the entire follow-up period of 24 months, 5 but it is unclear whether 24 months is the end point of postoperative recovery. 8 found that visual acuity continued to improve over a period of slightly less than 1 year after membrane peeling. 6 It seems clear that after surgery visual acuity continues to improve and retinal thickness decreases over an extended period, but reports on the outcome of surgery are inconsistent. Absence of a foveal pit did not preclude satisfactory postoperative visual acuity, 4 whereas others found that recovery of a normal foveal contour was associated with good visual acuity 3 months after surgery. 4 found that macular thickness returned to normal in only 3 of 62 eyes and that a foveal pit reappeared in 20 of 62 eyes 3 months after surgery. Time-domain OCT (tdOCT) has demonstrated increased retinal thickness of the macula, which decreased significantly after surgical membrane peeling 2 – 4, 7, 9 however, macular thickness after surgery was thicker in the operated compared with the normal unoperated fellow eyes 7 or normal control eyes. Optical coherence tomography (OCT) studies have added to the understanding of the morphologic alterations in IEM. Long-term observations are required in the assessment of macular recovery from mechanical stress. Long-term after surgery, the fovea and the nasal parafovea remain thickened between the outer nuclear layer and the ganglion cell layer, whereas the superior, temporal, and inferior macular thickness returns to normal. Superior, temporal, and inferior macular thickness returned to normal 12 to 14 months after surgery. Central macular thickness quantified with tdOCT remained increased, whereas the decrease of nasal macular thickness toward normal values was incomplete and delayed to 35 months after surgery. Twelve of 33 eyes had a foveal pit though the median foveal shape was distorted. Thickness of retinal layers between the outer nuclear and the ganglion cell plus inner plexiform layers in the horizontal midline of the fovea and the nasal parafovea was greater than normal, whereas that of the RPE, photoreceptor, and retinal nerve fiber layers was not different from controls. Macular thickness was quantified over time with the time-domain (td) OCT Fast Macular Thickness program. Raw images were exported, and the thickness of retinal layers was measured with a manual segmentation procedure aided by a customized computer program. The long-term postoperative course of macular thickness was followed.įdOCT scans were obtained from the horizontal midline in 33 eyes long-term (mean 46 ± 13 months) after surgery and in 30 eyes of age-matched controls. To better understand the long-term effect of idiopathic epiretinal membrane peeling on retinal anatomy, the foveal structure and the thickness of individual retinal layers were analyzed with frequency-domain optical coherence tomography (fdOCT).
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