Long-term Visual and Anatomical Outcome after Surgical Management of Epiretinal Membrane.

Objective: To assess the functional and surgical long-term outcomes following epiretinal membrane surgery.

Study Design: Case series.

Place And Duration Of Study: Layton Rahmatulla Benevolent Trust Tertiary Care Eye Hospital, Karachi, from January 2016 to December 2020.

Methodology: A medical record review was carried out of patients, who had undergone surgical management of ERM and had presented for follow-up for at least three years. Best corrected visual acuity (BCVA) and Optical Coherence Tomography (OCT) parameter [(integrity of ellipsoid zone (EZ)] was evaluated. BCVA, using Snellen's chart, is performed routinely on each visit, which was converted to logMAR chart for analysis in this study. OCT was also performed to evaluate the integrity of outer retinal layers using Heidelberg OCT.

Results: Sixty-five eyes of 54 patients were included in the study, including 41 eyes of 36 men (63%) and 24 eyes of 18 women (37%). Mean age was 46.2 ± 8.9 years. The mean BCVA significantly improved from 0.88 ± 0.28 logMAR (6/45 Snellen) preoperatively to 0.64 ± 0.21 (6/27) at the end of first year (p <0.001), which improved to 0.54 ± 0.19 (6/21) at the end of second year, and 0.53 ± 0.20 (6/20) after three years of follow-up. The post-op vision at three years was stratified according to the integrity of EZ on OCT performed at the same follow-up; and a significant difference was observed. EZ was intact in 52 eyes with a mean BCVA of 0.49 ± 0.16 logMAR (6/18 Snellen); while it was found disrupted in 13 eyes, where the BCVA was 0.68 ± 0.26 (6/29).

Conclusion: Anatomically intact outer retinal layer significantly correlated with improved BCVA. Key Words: Epiretinal membrane, Optical coherence tomograghy, Best corrected visual acuity.