Changes in Macular Area Following Epiretinal Membrane Removal and Its Correlation With Anatomical and Functional Parameters

Background and Objective: This study aimed to evaluate changes in macular area after pars plana vitrectomy (PPV) with epiretinal membrane (ERM) peeling and determine correlations with visual acuity (VA) and optical coherence tomography (OCT)–based anatomical parameters. Patients and Methods: This retrospective study included 29 eyes with idiopathic ERM undergoing PPV and membrane peeling. Macular area was quantified using infrared images at baseline and 7 to 9 days, and 30 days and 3 months postoperatively. OCT parameters—including central macular thickness (CMT), inner retinal thickness (IRT), macular volume, disorganization of retinal inner layers (DRIL), and ellipsoid zone (EZ) status—were analyzed. Correlations between macular area change, VA (logMAR), and OCT parameters were assessed. Results: Macular area significantly increased from 37.59 ± 11.67 mm 2 to 42.77 ± 10.92 mm 3 at 3 months ( P < .001). VA improved from 0.48 ± 0.19 to 0.20 ± 0.17 ( P < .001). CMT decreased from 508.68 ± 74.01 µm to 395.03 ± 63.62 µm ( P < .001). DRIL decreased from 82.8% to 31%. EZ disruption decreased from 37.9% to 17.2%; however, this change did not reach statistical significance (exact McNemar P = .070). Macular area change was not significantly correlated with visual acuity improvement at 3 months ( r = 0.081, P = .758), although macular area at 3 months was negatively correlated with CMT ( r = −0.560, P = .016). Conclusion: Macular area expansion after ERM peeling appears to reflect structural recovery following release of retinal traction. Although some associations with visual outcomes were observed, independent prognostic value remains uncertain and requires confirmation in larger prospective studies.