Epiretinal Membrane Peeling in Eyes with Pseudophakia: Prognostic and Morphological Factors of Visual Outcomes

Abstract Background Epiretinal membrane (ERM) is a sight-threatening disorder, and diagnosis can be delayed. In this study, spectral domain optical coherence tomography (SD-OCT) was used to investigate the predictive factors of visual outcomes in patients with pseudophakic ERM following surgery. Methods The records of 61 patients with pseudophakic eyes (61 eyes) with ERM who underwent PPV, ERM peeling, and ILM peeling were retrospectively reviewed. OCT features such as central foveal thickness (CFT), cotton ball sign, ERM foveoschisis, ellipsoid zone (EZ) disruption, external limiting membrane (ELM) disruption, ectopic inner foveal layer (EFIL), disorganization of the retinal inner layers (DRIL), dissociated optic nerve fiber layer (DONFL), and microcystic macular edema (MME), as well as surgical factors, were compared before and after surgery. The correlations between the OCT and surgical factors and change of best-corrected visual acuity (BCVA) before and after the surgery were examined. Results The mean follow-up time was 6 months. The BCVA (P < 0.01) and CFT (P < 0.01) showed significant improvements after ERM removal (P < 0.01). Cotton ball sign and DRIL exhibited statistically significant improvement after ERM removal. ERM-foveoschisis (P = 0.015) and MME (P = 0.009) were significantly correlated with less improvement of visual acuity. Better visual acuity before surgery was significantly associated with better improvement of visual acuity (P < 0.001). Conclusions Better baseline visual acuity is correlated with better visual acuity improvement after surgery, while ERM foveoschisis and MME identified preoperatively on OCT are associated with relatively less improvement of visual acuity.