Comparison of Structural Changes after Epiretinal Membrane Peeling between Nonglaucomatous Eyes and Eyes with Open-Angle Glaucoma.

Ophthalmol Glaucoma

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Published: March 2025

Purpose: To compare the structural changes in the peripapillary and macular regions following pars plana vitrectomy (PPV) with epiretinal membrane (ERM) peeling between nonglaucomatous eyes and eyes with primary open-angle glaucoma (POAG).

Design: Retrospective, longitudinal, observational study.

Participants: 68 eyes (34 POAG and 34 nonglaucomatous eyes) that underwent PPV with ERM peeling surgery METHODS: This retrospective study analyzed 68 eyes (34 POAG and 34 nonglaucomatous eyes) that underwent PPV with ERM peeling surgery. The circumpapillary retinal nerve fiber layer (RNFL) thickness, central macular thickness (CMT), and interdigitation zone (IZ) defects were assessed using spectral-domain optical coherence tomography before and 6 months after surgery, and compared between nonglaucomatous and POAG eyes.

Main Outcome Measures: Comparison of structural changes between POAG Eyes and Nonglaucomatous Eyes after PPV with ERM Peeling Surgery RESULTS: Both nonglaucomatous and POAG eyes showed significant reductions in CMT and temporal RNFL thicknesses postoperatively, but significant increases were observed in nasal RNFL thicknesses. However, the changes were less prominent in POAG eyes, with significantly smaller decreases in CMT (P=0.044) and temporal RNFL thickness (P=0.020), and smaller increases in the nasal (P=0.022) and inferonasal (P=0.005) RNFL thicknesses. In nonglaucomatous eyes, the length of the IZ defect decreased significantly postoperatively (P=0.009), while no significant change was observed in POAG eyes (P=0.115).

Conclusions: Structural changes in the macula and peripapillary areas following PPV with ERM peeling were less pronounced in POAG eyes than in nonglaucomatous eyes, probably due to preexisting optic nerve damage. These different structural outcomes should be considered in diagnosing and monitoring of glaucoma in patients accompanied by ERM.

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http://dx.doi.org/10.1016/j.ogla.2025.03.001DOI Listing

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