Inner Segment/Outer Segment Junction Assessed by Spectral-Domain Optical Coherence Tomography in Patients with Idiopathic Epiretinal Membrane

Inoue, Maiko; Morita, Satoshi; Watanabe, Yoichiro; Kaneko, Tetsuji; Yamane, Shin; Kobayashi, Satoshi; Arakawa, Akira; Kadonosono, Kazuaki

doi:10.1016/j.ajo.2010.06.006

« Previous Next »American Journal of Ophthalmology
Volume 150, Issue 6 , Pages 834-839, December 2010

Inner Segment/Outer Segment Junction Assessed by Spectral-Domain Optical Coherence Tomography in Patients with Idiopathic Epiretinal Membrane

Maiko Inoue
- Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan
- Inquiries to Maiko Inoue, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, Japan
Satoshi Morita
- Department of Biostatistics and Epidemiology, Yokohama City University Medical Center, Yokohama, Japan
Yoichiro Watanabe
- Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan
Tetsuji Kaneko
- Department of Biostatistics and Epidemiology, Yokohama City University Medical Center, Yokohama, Japan
Shin Yamane
- Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan
Satoshi Kobayashi
- Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan
Akira Arakawa
- Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan
Kazuaki Kadonosono
- Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan

Accepted 12 June 2010. published online 18 August 2010.

Purpose

To evaluate the anatomic features of the photoreceptor inner/outer segment (IS/OS) junction before and after surgery by spectral-domain optical coherence tomography in patients undergoing idiopathic epiretinal membrane (ERM) surgery and to correlate these features with the functional outcomes.

Design

Prospective, cohort study.

Methods

We prospectively studied 45 eyes of 45 patients with idiopathic epiretinal membrane who had a preoperative visual acuity of 20/32 or less and were scheduled to undergo transconjunctival 25-gauge vitrectomy. The patients were divided into 2 groups based on the preoperative structural integrity of the IS/OS junction: the intact IS/OS junction group and the disrupted IS/OS junction group. Changes in the IS/OS junction and best-corrected visual acuity were compared between 2 groups before and at 3, 6, and 12 months after surgery.

Results

A total of 45 patients were recruited for this study. There were 34 eyes with an intact IS/OS junction (group 1) and 11 eyes with a disrupted or irregular IS/OS junction (group 2), as determined before surgery. Significantly better postoperative best-corrected visual acuity was seen in group 1 as compared with that in group 2 at 3, 6, and 12 months after the surgery (P < .001). Significant improvement of visual acuity was also seen in group 1 when compared to group 2 (P < .05). Of the 34 eyes in group 1, 17 (50%) showed disruption of the IS/OS junction at 3 months after surgery, although this disruption was only transient and resolved completely by 12 months after the surgery. However, none of the eyes from group 2 showed a normal appearance of the IS/OS junction at any time point during the study period of 1 year.

Conclusions

The IS/OS junction can recover in eyes with preoperative intact IS/OS junction as assessed over a follow-up period of 1 year after surgery. Preoperative integrity of the IS/OS junction may be an important prognostic factor for better visual recovery and better improvement of the postoperative best-corrected visual acuity after epiretinal membrane surgery.