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Abstract
Objective
To evaluate the characteristics and prognoses of idiopathic macular epiretinal membrane (iERM) using a classification based on the foveal avascular zone (FAZ) area.
Method
IERMs were classified into four stages based on the FAZ area. Baseline FAZ-related parameters, pre-and postoperative central macular thickness (CMT), and best corrected visual acuity (BCVA) were observed and compared between different stages. The correlations of structural parameters with pre-and postoperative logMAR BCVA were analyzed.
Results
162 iERM eyes were enrolled, including 105 eyes followed up for 12 months after surgery. The preoperative BCVA was better at the early stage. Postoperative BCVA at Stages 2 and 3 were better compared to Stage 4. The early stage was associated with thinner CMT pre-and postoperatively. However, there was no significant difference in CMT between postoperative Stages 1 and 2 or Stages 3 and 4. Preoperative logMAR BCVA was negatively correlated with FAZ area, perimeter, and FD-300 and was positively correlated with CMT and acircularity index (AI). CMT correlated positively with BCVA for each stage, except Stage 4; FAZ area, perimeter, and FD-300 had a negative correlation at Stage 1. Baseline BCVA and CMT positively correlated with BCVA at the last follow-up, while FAZ area and FD-300 were negatively correlated. Baseline BCVA had a positive correlation for each stage, except Stage 1; FD-300 had a negative correlation at Stages 2 and 3; CMT had a positive correlation at Stage 3.
Conclusion
A classification based on the FAZ area was established innovatively. This classification can reflect the progression of iERM and is helpful to the postoperative prognosis.
KEY MESSAGES:
(1) Classification based on FAZ area facilitate automation and consistency compared to the previous OCT-based qualitative grading.(2) With baseline FAZ stage advanced, thickened CMT and worsened BCVA was observed at baseline and 1-year post-operation. (3) Baseline FAZ area and FD-300 negatively correlated with logMAR BCVA at the last follow-up, reflecting the nonnegligible prognostic impact of macular vascular changes.
Authors’ contributions
Lijun Shen, Jianbo Mao, and Zhengxi Zhang contributed to the conception and design of the study; Jianbo Mao, Zhengxi Zhang, Jimeng Lao, Xinyi Deng, Yuyan Fang, and Nuo Chen performed the experiment; Zhengxi Zhang, Jimeng Lao, Chenyi Liu, and Yiqi Chen contributed to the the analysis and interpretation of the data; Zhengxi Zhang, Jimeng Lao, Xinyi Deng, Yuyan Fang, and Nuo Chen drafted the paper; Lijun Shen, Zhengxi Zhang, Jianbo Mao, Chenyi Liu, and Yiqi Chen revised it critically for intellectual content. All authors performed the final approval of the version to be published and agreed to be accountable for all aspects of the work, ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
The data supporting this study’s findings are available on reasonable request from the corresponding author, Shen L. However, the data are not publicly available because they contain information that could compromise the privacy of the research participants.