The Application Of Microperimetry In Evaluating The Functional Changes Of Idiopathic Macular Epiretinal Membrane Patients Preoperatively And Postoperatively

Purpose:Using Microperimetry to evaluate the functional changes of the macular while using Optical Coherence Tomography to evaluate the morphology recovery of the retina in idiopathic epiretinal membrane patients, and then have correlation analysis with Best Corrected Visual Acuity.Methods:A prospective cohort study. Twenty-eight patients (twenty eight eye) received twenty-three Gaunge pars plana vitrectomy as well as epiretinal membrane peeling. Functional and structural changes of macular before the surgery and at follow-up visits were recorded for analysis, including using Microperimetry(MP-1) to evaluate the mean retinal sensitivity^fixation stability and fixation location, using charts to evaluate Best Corrected Visual Acuity(BCVA, LogMAR), and using Optical Coherence Tomography to evaluate central foveal thickness and continuity of the photoreceptor inner and outer segment(IS/OS) junction.Results:Twenty-eight eyes were followed for at least one year after surgery. Postoperatively, the mean logarithm of the minimum angle of resolution best corrected visual acuity improved from0.780to0.364,significantly better(Z=-4.247,P<0.01) than the preoperative one. Microperimetry demonstrated that mean retinal sensitivity within the central12°field improved from (12.58±5.25dB) at baseline to (15.47±4.23dB) at the last visit, significantly higher than the preoperative one(t=-4.193,P<0.01). The fixation location percentage improved from (57.607+35.815%) at baseline to (71.607±30.432%) at the last visit, higher than the preoperative one (t=-2.784,P=0.01). Six of the fourteen eyes with either an unstable or relatively unstable fixation established stable fixation at12months. The CFT was significantly thinner(t=5.090,P<0.01) than the preoperative one. To have correlation analysis for postoperative BCVA at12months with preoperative data, and it turns out that it is significantly correlated with preoperative BCVA and preoperative mean sensitivity. However, merely preoperative mean retinal sensitivity were suggested to be quantitatively predictive for the visual prognosis by multiple stepwise linear regression analysis.Conclusions:Vitrectomy combined with macular epiretinal membrane removal could effectively benefit the macular recovery functionally and structurally. Meanwhile the preoperative mean retinal sensitivity detected by microperimetry may help to predict the prognosis of surgery objectively in patients with iERM more effectively than preoperative BCVA.