Epiretinal Membrane Clinical Trial
Official title:
Evaluation of Multifocal ERG and Visual Field Changes After Vitrectomy and ILM Peeling
To evulate changes in MfERG, VF and OCT after viterctomy associated with ILM peeling.
Macular epiretinal membrane (ERM) is a disorder of the vitreomacular interface characterized
by fibrocellular proliferation on the anterior surface of the internal limiting membrane (ILM)
of the macula. Pars plana vitrectomy with ERM removal and inner limiting membrane peeling is
the standard surgical treatment for an ERM. ILM peeling is performed to eliminate the
scaffold for myofibroblast proliferation and any microscopic ERM in order to prevent ERM
recurrence. ILM peeling is indicated for other pathologies other than ERM such as, diabetic
macular edema, and macular hole. ILM peeling is a traumatic procedure that may have many
effects on the underlying inner retinal layers that may lead to changes in retinal function.
Retinal edema, eccentric scotoma, dissociation of the nerve fiber layer, iatrogenic punctuate
chorioretinopathy, and subretinal, retinal, and vitreous hemorrhage are well described
secondary to the surgical trauma of peeling in addition to stain toxicity. Investigation of
these changes may assist in aiding the development of minimally traumatic techniques for ILM
removal .
Evaluation of functional changes may include visual field and Multifocal electroretinography
assessment. Visual field defect after vitrectomy a well known post operative complication
usually in eyes that underwent fluid air exchange, the cause of visual field defect remain
unclear.
Optical Coherence Tomography (OCT), imaging is done to evaluate inner retinal layers after
ILM peeling,High myopic eyes might develop more severe, "scattered" inner retinal defects
after ILM peeling.
Multifocal electroretinography (mfERG), has been used to assess visual function and the
electrophysiologic responses of multiple retinal locations of the macular area
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