Effect of Internal Limiting Membrane Peeling on Macular and Optic Disc Vascular Density Following Epiretinal Membrane Surgery

OBJECTIVES: To investigate the effect of internal limiting membrane peeling on vascular density of macula and optic disc in idiopathic epiretinal membrane surgery.
METHODS: Thirty-six eyes of 36 patients who underwent combined phacoemulsification with intraocular lens implantation followed by pars plana vitrectomy and epiretinal membrane (ERM) removal were prospectively included in this study. Based on the intraoperative status of the internal limiting membrane (ILM) after ERM removal, the eyes were classified into two groups: The ILM-peeled group (n=22) and the ILM-unpeeled group (n=14). Vascular density of superficial capillary plexus, deep capillary plexus, optic nerve head and radial peripapillary capillary plexus were obtained by optical coherence tomography angiography before and up to 3 months after surgery.
RESULTS: After surgery, superficial capillary plexus fovea vascular density and foveal thickness decreased significantly in the internal limiting membrane unpeeled group. (p=0.016; p=0.048 respectively). There was no significant change in superficial capillary plexus paravofea (p=0.257), deep capillary plexus fovea (p=0.569), deep capillary plexus parafovea (p=0.457), optic nerve head (p=0.545) and radial peripapillary capillary plexus (p=0.975) vascular density comparison between groups.
DISCUSSION AND CONCLUSION: Internal limiting membrane peeling has no significant effect on deep capillary plexus and the optic disc vascular density, but can reduce vascular density in the superficial capillary plexus after idiopathic epiretinal membrane peeling surgery.

Keywords: Internal limiting membrane, epiretinal membrane surgery, optical coherence tomography angiography, macula vascular density, optic disc vascular density