Purpose: To prospectively compare microvascular changes of internal limiting membrane (ILM) peeled and nonpeeled eyes in patients with idiopathic epiretinal membranes using optical coherence tomography angiography.
Methods: Forty-two patients with epiretinal membranes underwent vitrectomy with (n = 22) or without ILM peeling (n = 20). The mean superficial capillary plexus foveal avascular zone area change between preoperative and three-month postoperative readings served as the main outcome measure. Secondary outcome parameters included mean changes in superficial capillary plexus parafoveal vessel density, central foveal thickness, retinal volume, and best-corrected visual acuity.
Results: Mean superficial capillary plexus foveal avascular zone area change (μm 2 ) was 59 ± 74 in the ILM nonpeeling group compared with -12 ± 86 in the ILM peeling group ( P = 0.007). Similarly, mean superficial capillary plexus parafoveal vessel density change (%) was higher in the ILM nonpeeling group (ILM nonpeeling 4 ± 4, ILM peeling -2 ± 6, P = 0.003). The mean retinal volume reduction was higher in the ILM peeling group, and this difference also reached statistical significance ( P = 0.036). There were no intergroup differences in mean central foveal thickness change and mean best-corrected visual acuity change ( P = 0.409 and P = 0.440, respectively). Epiretinal membrane/ILM separation was achieved in 23 of 51 patients.
Conclusion: The macular microvasculature demonstrated more remodeling in the ILM nonpeeling group after three months.
Trial registration: ClinicalTrials.gov NCT05287009.