Aims To evaluate the visual function and foveal architecture in patients with stage 3 idiopathic epiretinal membrane (iERM). Methods A cross-sectional observational study included 56 eyes of 52 patients with stage 3 iERM. The patients were classified into type A ectopic inner foveal layers (EIFL) and type B EIFL based on the presence of a continuous hyporeflective band. Visual function and foveal microarchitecture were assessed in enrolled eyes. Best-corrected visual acuity (BCVA), metamorphopsia scores, retinal sensitivity and optical coherence tomography (OCT)/OCT angiography features were compared between two subtypes. Result The BCVA in type A EIFL and type B EIFL was 0.22 logarithm of minimal angle of resolution (logMAR) (0.15 logMAR, 0.40 logMAR) and 0.53±0.23 logMAR, respectively (p=0.002). Type B EIFL had higher average metamorphopsia scores, especially horizontal metamorphopsia scores, than type A (p=0.013, p=0.007, respectively). Type B EIFL had worse central 2° foveal sensitivity than type A (p=0.034). Type B EIFL had thicker central foveal thickness and EIFL thickness (514.08±73.80 µm vs 444.41±56.57 µm, p=0.001; 159.75±78.30 µm vs 48.44±18.37 µm, p<0.0001; respectively). The foveal avascular zone area of type B EIFL was smaller than that of type A (0.042±0.022 mm2 vs 0.077±0.039 mm2, p<0.0001). The vessel density and flow area of the superficial vascular complex in type B EIFL were larger than those in type A (both p=0.001). Conclusions Type B EIFL demonstrated significantly worse visual function than type A EIFL, along with marked differences in foveal microstructure and microvasculature. Our study complements the current staging of iERM and helps determine the optimal timing of iERM surgery. Data are available upon reasonable request.

中文翻译：

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亚型 3 期视网膜前膜：异位内中央凹层结构及其临床意义的全面研究


目的 评价 3 期特发性视网膜前膜 （iERM） 患者的视觉功能和中心凹结构。方法 一项横断面观察性研究包括 52 例 3 期 iERM 患者的 56 只眼睛。根据连续低反射带的存在，将患者分为 A 型异位内中心凹层 （EIFL） 和 B 型 EIFL。在入组的眼睛中评估视觉功能和中心凹微结构。比较两种亚型的最佳矫正视力 （BCVA） 、视物改观评分、视网膜敏感性和光学相干断层扫描 （OCT）/OCT 血管造影特征。结果 A 型 EIFL 和 B 型 EIFL 的 BCVA 分别为最小分辨率角 （logMAR） 的 0.22 对数 （0.15 logMAR、0.40 logMAR） 和 0.53±0.23 logMAR （p=0.002）。B 型 EIFL 的平均评分，尤其是水平变视评分高于 A 型 （分别为 p=0.013、p=0.007）。B 型 EIFL 的中央 2° 中心凹敏感性比 A 型差 （p=0.034）。B 型 EIFL 的中央凹厚度和 EIFL 厚度较厚 （分别为 514.08±73.80 μm vs 444.41±56.57 μm，p=0.001;分别为 159.75±78.30 μm vs 48.44±18.37 μm，p<0.0001;B 型 EIFL 的中心凹无血管区面积小于 A 型 （0.042±0.022 mm2 vs 0.077±0.039 mm2，p<0.0001）。B 型 EIFL 浅表血管复合体的血管密度和流面积大于 A 型 （均 p=0.001）。结论 B 型 EIFL 的视觉功能明显差于 A 型 EIFL，同时中心凹微观结构和微血管系统存在显著差异。我们的研究补充了 iERM 的当前分期，并有助于确定 iERM 手术的最佳时机。数据可根据合理要求提供。