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Purpose: The aim of this study is to assess the prognostic value of a classification system that includes the presence of ectopic inner foveal layers and other anatomical variables identified in spectral-domain optical coherence tomography for idiopathic epiretinal membrane (ERM) surgery. Methods: A descriptive-analytic, longitudinal, retrospective study was conducted on patients with idiopathic ERMs treated with pars plana vitrectomy from January 2017 to December 2021. Clinical data and spectral-domain optical coherence tomography images were reviewed presurgery and 12 months postsurgery. The primary outcome measured was best-corrected visual acuity (BCVA) before and after surgery, analyzing the impact of anatomical factors on BCVA in patients undergoing ERM surgery. Results: This study included 342 eyes from 323 patients. Postsurgical evaluations showed significant reductions in central foveal thickness across all ERM stages, with most Stage 4 ERMs regressing to Stage 3. The mean improvement in BCVA was significant for all stages, with earlier stages showing better results. The presence of macular edema and ellipsoid zone disruption were significant predictors of postsurgical BCVA, while disorganization of the retinal inner layer showed an association with visual recovery but was not conclusively predictive. Conclusion: This study highlights the importance of spectral-domain optical coherence tomography in assessing retinal changes in idiopathic ERMs, demonstrating the prognostic value of ectopic inner foveal layers stage scheme and other anatomical variables such as ellipsoid zone disruption and macular edema presence on BCVA. These findings offer insights into surgical prognostication and the potential for personalized treatment strategies.
Mansilla et al. (Fri,) studied this question.