A Comparative Analysis of the Clinical and Functional Results of Surgical Treatment for Idiopathic Epiretinal Fibrosis at Different Stages of the Pathological Process

    Abstract

    A Comparative Analysis of the Clinical and Functional Results of Surgical Treatment for Idiopathic Epiretinal Fibrosis at Different Stages of the Pathological Process.

    S.A. Borzenok , S.V. Kolesnik, I.M. Gorshkov, A.I. Kolesnik, A.V. Miridonova, F.A. Avakyan, L.L. Arutyunyan

    S. Fyodorov Eye Microsurgery Federal State Institution, Moscow
A. Evdokimov Moscow State Medical and Dental University, Department of Ophthalmology, Moscow
I. Sechenov First Moscow State Medical University (Sechenov University), Moscow

    Idiopathic ERM is a fibrocellular proliferation on the inner surface of vitreomacular interface. Vitrectomy in patients with relatively high preoperative visual acuity is preferable, because it prevents further photoreceptor damage. In the late stages of the disease, patients are not satisfied with the results of the treatment after surgical removal of the ERM due to fibrotic remodeling of the vitreomacular interface. The main reason for this is the incompleteness of the retinal morphology restoration and function.

    Purpouse. To compare the anatomical and clinical functional results of surgical treatment in patients with different visual acuity at different periods of observation.

    Material and methods. A clinical and functional assessment of early surgical treatment of idiopathic ERM was performed in 75 patients (75 eyes). It consists in the dynamic observation of the best-corrected visual acuity (BCVA), data of central retinal thickness (CRT) and central retinal sensitivity (CRS).

    Results. The BCVA of patients from the 1st group was 1.00 (0.80; 1.00) already 6 months after the treatment. Also, as soon as possible, the CRS was restored to 27.25 (26.50; 27.90) dB. In the 2nd group, the BCVA and CRS were revealed by the 12th month of observation 0.80 (0.60; 0.90), RS 26.20 (24.50; 27.00). In the 3rd group, BCVA at the end of the entire observation period did not reach maximum values – 0.50 (0.30; 0.60), CRS 23.70 (22.10; 24.75). Increasing of BCVA correlated with the retinal thickness decreasing.

    Conclusions. Combined surgical treatment for early symptomatic ERM is effective, safe and appropriate to maintain high anatomical and functional results in the postoperative period, which allows to achieve rapid rehabilitation of patients.

    Key words: idiopathic epiretinal membrane, combined surgical treatment, symptomatic ERM, early surgical intervention