Effect of Internal Limiting Membrane Peeling or Not on Blood Flow Signal in Macular Area of Diabetic Patients with Preretinal Membrane

Abstract

Purpose

To study the effect of intraoperative internal limiting membrane (ILM) peeling on the macular vascular structure in patients with diabetic epiretinal membrane (ERM).

Methods

Patients with diabetic ERM were divided into an ERM + ILM peeling group (18 eyes) and an ERM peeling group (19 eyes), all of whom underwent standard vitrectomy and were followed up until 6 months postoperatively. Best-corrected visual acuity (BCVA), Central macular thickness (CMT), Vessel density (VD) and vessel length density (VLD) of the superficial as well as deep retinal capillary plexus were compared between the two groups.

Results

There was no significant difference in BCVA (p = .188, .410, .901, .916) and CMT (p = .164, .128, .110, .105) between the two groups at the week 1, month 1, month 3 and month 6 after operation. In the superficial capillary plexus (SCP), the change in VD (p = .106) and VLD (p = .438) was not affected by ILM peeling, and there was no significant difference in VD (p = .154, .063, .100, .162) and VLD (p = .386, .263, .431, .391) between the two groups during the four follow-up after operation. For the deep capillary plexus (DCP), there was an effect of ILM peeling on the changes in VD (p = .024) and VLD (p = .012), ILM peeling delayed the recovery time of the VD and VLD; The VD (p = .026, .000, .003) and VLD (p = .005, .000, .000) of ERM + ILM peeling group were lower than those of ERM peeling group from the month 1 to the month 6 after operation.

Conclusion

Intraoperative peeling of the ILM in patients with diabetic ERM delayed the improvement of blood flow signal in the DCP but did not affect the recovery of postoperative BCVA and CMT.

Keywords:

• Diabetes
• Epiretinal membrane
• Inner limiting membrane
• vessel density
• vessel length density

Author contributions

Heng Li was responsible for study design and patient surgery, Bo Li and Yanjun Du was responsible for data collection and manuscript writing, Wenjun Gou and Liying Yan was responsible for patient follow-up and data statistics, Hui You and Mengtian Bai were responsible for patient follow-up and data collection, and Chen Xie was responsible for data compilation and doctor-patient communication.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Availability of data and materials

Relevant data is available at https://figshare.com/s/aa22c3d20a9ce3cda341

Additional information

Funding

This work was supported by the Scientific Research Project of Suining Central Hospital [No:2022ypj25].