The Correlation Between OCT Detection Of Retinal Hyperreflective Bodies Combined With Structural Indicators And The Prognosis Of Macular Epiretinal Membrane Treatment

Objective: To investigate the changes of structural markers and Hyperreflective foci(HRF)in patients with Idiopathic macular epiretinal membrane(IMEM)before and after surgery.The indexes related to postoperative visual acuity recovery in IMEM patients were also explored.Methods: Twenty-seven patients(27 eyes)who presented to Guangxi Zhuang Autonomous Region People’s Hospital from August 2021 to December2022 and were diagnosed with IMEM on comprehensive examination were selected for inclusion in the study.All patients underwent 25 G minimally invasive vitrectomy combined with macular anterior and internal boundary membrane debridement at our institution.Best corrected visual acuity(BCVA),optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA)were performed preoperatively and 3 months postoperatively.The number of retinal HRF,central macular thickness(CMT),macular epiretinal membrane(MEM)area,central macular avascular area(Foveal avascular area)were compared between preoperative and 3 months postoperative.Foveal avascular area(FAZ)area,Ectopic inner foveal layers(EIFL),non-circular index(AI),Outer nuclear layer thickness(ONLT),and the correlation between each index and BCVA were investigated.The correlation between these indices and BCVA was analyzed.Results: 1.Analysis of Indexes before and after OperationBCVA(log MAR)was higher in IMEM patients 3 months after surgery than before surgery(t=3.238,P=0.003).The number of HRFS decreased(P=0.000,Wilcoxon rank sum test).EIFL decreased 3 months after surgery compared with that before surgery(P=0.001,Wilcoxon rank sum test).The AI before and after operation was statistically significant(t=-2.964,P=0.006).The thickness of CMT was reduced 3 months after surgery(P=0.000,Wilcoxon rank sum test).ONLT showed a downward trend 3 months after surgery,and there was no significant difference before and after surgery(P=0.280,Wilcoxon rank sum test).The area of FAZ increased 3 months after operation compared with that before and after operation,and the difference was not statistically significant(t=-0.306,P=0.762).2.Correlation AnalysisIn IMEM patients,there was a significant correlation between preoperative BCVA(log MAR)and the number of HRF before surgery(rs=0.950,P=0.000),and there was a significant correlation between BCVA(log MAR)and the number of HRF at 3 months after surgery(rs=0.891,P=0.000).The number of preoperative HRFS was significantly correlated with BCVA(log MAR)at 3months after surgery(rs=0.425,P=0.027).Preoperative EIFL was positively correlated with CMT and MEM area(rs=0.651,P=0.000;rs=0.511,P=0.006).Preoperative FAZ area was positively correlated with preoperative AI(rs=0.602,P=0.001).Preoperative ONLT was positively correlated with preoperative CMT(rs=0.469,P=0.014).ONLT at 3months after surgery was positively correlated with CMT at 3 months after surgery(rs=0.442,P=0.021).ONLT at 3 months after surgery was positively correlated with AI at 3 months after surgery(rs=0.452,P=0.018).There was a significant positive correlation between preoperative EIFL and CMT at 3 months after surgery(rs=0.475,P=0.012).Preoperative ONLT was positively correlated with CMT at 3 months after surgery(rs=0.545,P=0.003).There was a significant positive correlation between preoperative ONLT and AI at 3 months after surgery(rs=0.466,P=0.014).Preoperative CMT was negatively correlated with FAZ area at 3 months after surgery(rs=-0.402,P=0.038).The difference of BCVA(log MAR)before and after surgery was significantly positively correlated with the difference of HRF number(rs=0.789,P=0.000).The difference of BCVA(log MAR)before and after surgery was positively correlated with the difference of EIFL(rs=0.508,P=0.007).Conclusion: 1.The decrease in the number of HRF in the retina is positively correlated with the improvement of postoperative visual acuity in IMEM patients,and the number of HRF may be used as a predictor of postoperative visual acuity recovery in IMEM patients.2.The decrease of EIFL thickness is significantly correlated with the improvement of postoperative BCVA in IMEM patients.3.FAZ,CMT,ONLT,and MEM area were not correlated with the prognosis of IMEM patients.4.Vitrectomy combined with peeling of epimacular membrane and internal limiting membrane can effectively improve visual acuity in patients with IMEM.