Morphologic assessment of photoreceptors after idiopathic epiretinal membrane surgery with adaptive-optics SLO

TL;DR

This study uses advanced imaging to show that photoreceptor structure is altered after a specific eye surgery, affecting vision recovery.

Contribution

AO-SLO is demonstrated as a novel quantitative tool for assessing photoreceptor changes post-idiopathic epiretinal membrane surgery.

Findings

Post-surgery eyes showed reduced cone density and regularity with increased dispersion compared to healthy eyes.

Cone density correlated negatively with visual acuity and retinal thickness in specific regions.

AO-SLO revealed persistent photoreceptor abnormalities linked to incomplete visual recovery.

Abstract

This study aims to quantitatively assess morphological alterations in cone cells following idiopathic epiretinal membrane (IERM) surgery using adaptive optics scanning light ophthalmoscopy (AO-SLO) and to correlate these findings with retinal structure, retina vascular characteristic and visual function.

This cross-sectional analysis involved seventeen eyes from 17 patients who underwent IERM surgery, compared to a control group of 35 demographically matched subjects. Comprehensive ophthalmologic evaluations were performed, including AO-SLO, Optical coherence tomography (OCT), and Optical coherence tomography angiography (OCTA). The study focused on assessing post-surgery cone density, dispersion, and regularity, as well as their relationship with visual function, macular structure, and macular vessel characteristics.

A significant reduction in cone densities and regularity, along with a substantial increase in cone dispersion, were observed in all quadrants of eyes after IERM surgery compared to healthy eyes (mean cone densities: t=-4.76; P < 0.001; mean cone regularity: t=-5.11, P < 0.001; mean cone dispersion: t = 5.56, P < 0.001). Negative correlations were found between cone densities and best-corrected visual acuity (BCVA) (ρ=-0.62, P < 0.001). Additionally, average cone density correlated negatively with inner retinal thickness, particularly in the inferior quadrants (ρ = -0.42, P = 0.03), and with vascular density of the superficial capillary plexus (SCP) in the fovea (ρ = -0.39, P = 0.04), as indicated by OCTA.

The assessments of cone morphology using AO-SLO demonstrated persistent deviations from typical photoreceptor arrangements after IERM surgery, which are significantly associated with incomplete recovery of visual function. AO-SLO serves as an effective quantitative tool for identifying photoreceptor abnormalities in eyes after IERM surgery.

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