Inner nuclear layer thickness helps predict metamorphopsia after vitrectomy

Issue: December 25, 2015

Inner nuclear layer thickness reliably predicted metamorphopsia before and after vitrectomy for epiretinal membrane, according to a study.

Perspective from Jay S. Duker, MD

The prospective study included 53 eyes of 53 patients who underwent vitrectomy for idiopathic epiretinal membrane.

Visual acuity, severity of metamorphopsia and retinal microstructures were examined preoperatively and 3 months and 6 months postoperatively. M-Charts (Inami) were used to quantify severity of metamorphopsia, and spectral-domain OCT was used to image retinal microstructures.

An image processing program was used to analyze central foveal thickness, parafoveal retinal thickness, macular volume, thickness of the ganglion cell layer, inner nuclear layer and outer retinal layer. Investigators also evaluated the status of the outer retinal lines.

Before surgery, the mean metamorphopsia score (M-score) correlated strongly with central foveal thickness (P < .05), mean inner nuclear layer thickness (P < .0001), and mean outer nuclear layer and outer plexiform layer thickness (P < .05).

At 6 months after surgery, the mean M-score correlated strongly with central foveal thickness (P < .005) and mean inner nuclear layer thickness (P < .0005).

There was a significant association between mean M-score at 6 months postoperatively and mean preoperative inner layer thickness (P < .005).

A statistically significant relationship existed between the mean preoperative M-score and mean M-scores at 3 months (P < .001) and 6 months (P < .01) after surgery. – by Matt Hasson

Disclosure: The authors report no relevant financial disclosures.

Perspective

Jay S. Duker, MD

Patient satisfaction following epiretinal membrane (ERM) surgery is correlated with improvement in metamorphopsia as well as visual acuity. Okamoto and co-authors show a correlation between structure (inner nuclear thickness on OCT) and function (M-score) in 53 eyes undergoing successful ERM surgery. While of interest, until OCT devices can determine inner nuclear thickness accurately and in an automated fashion, this important association will be difficult to apply to clinical practice.

Jay S. Duker, MD

OSN Retina/Vitreous Board Member

Disclosures: Duker reports he is a consultant for Carl Zeiss Meditec and OptoVue.

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Sources/Disclosures

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Source:

Okamoto F, et al. Retina. 2015;doi:10.1097/IAE.0000000000000602.