Correlation between foveal cone outer segment tips line and visual recovery after epiretinal membrane surgery

Invest Ophthalmol Vis Sci. 2013 Nov 5;54(12):7302-8. doi: 10.1167/iovs.13-12702.


Purpose: To determine whether there is a significant correlation between the integrity of the foveal microstructures and the best-corrected visual acuity (BCVA) after pars plana vitrectomy for epiretinal membrane (ERM) removal.

Methods: This was a retrospective, interventional case series. Forty-six eyes of 45 patients with an ERM underwent vitrectomy. The foveal area was examined by spectral-domain-optical coherence tomography (SD-OCT) preoperatively and postoperatively. The correlation between the length of the photoreceptor cone outer segment tips (COST) line defect, the inner segment/outer segment junction (IS/OS) line defect, the external limiting membrane (ELM) line defect, and the BCVA was determined.

Results: The length of the COST line defect was significantly correlated with the BCVA at postoperative 1, 3, 6, 9, and 12 months (P < 0.001 for all). Forward stepwise regression analyses showed that the postoperative BCVA was significantly correlated with the length of COST line defect (P < 0.001) but not with the IS/OS line and ELM line defects for up to 6 months. The preoperative length of the COST line defect was significantly correlated with the postoperative BCVA at 12 months (P = 0.005), but the lengths of the IS/OS line defect and ELM line defect were not. The factor that best predicted the postoperative BCVA was the length of the preoperative COST line defect (P = 0.04) but not the preoperative BCVA (P = 0.69).

Conclusions: The recovery of the foveal COST line defect is correlated with the BCVA after ERM surgery. The length of the preoperative COST line defect can predict the potential foveal function. ( number, NCT01549249.).

Keywords: cone outer segment tips; idiopathic epiretinal membrane; inner segment/outer segment junction; pars plana vitrectomy; spectral-domain optical coherence tomography.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Epiretinal Membrane / physiopathology*
  • Epiretinal Membrane / surgery
  • Female
  • Fovea Centralis / pathology*
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Recovery of Function / physiology
  • Regression Analysis
  • Retinal Photoreceptor Cell Inner Segment / pathology
  • Retinal Photoreceptor Cell Outer Segment / pathology*
  • Retrospective Studies
  • Tomography, Optical Coherence / methods
  • Visual Acuity / physiology*
  • Vitrectomy

Associated data