1. Evaluation and comparison with control group of flux density in superficial, deep, choroidal and retinal capillary plexuses and retinal sensitivity in clinically healthy contralateral eyes of patients with idiopathic epiretinal membranes (iERM)

The formation of idiopathic macular epiretin membranes (iERM) is a relatively frequent cause of visual deficiency which tends to increase in frequency with age. The formation of such membranes appears to be correlated to mechanical phenomena related to the detachment of the vitreous, however, there are elements to hypothesize that pre-existing alterations at the level of the retina itself may predispose the eye to the onset of this pathology.

The purpose of the study is to investigate with a prospective observational study the macular retinal ultrastructure of the healthy contralateral eye, both anatomically and functionally, in selected cases of patients presenting iERM in one eye. The study will involve a sophisticated anatomical evaluation with state-of-the-art retinal imaging instrumentation (swept-source OCTs, angio-OCT) and advanced layer-by-layer functional analysis (microperimetry, mfERG, PERG, FERG). In particular, possible differences between control group and study group in blood flow at the level of homologous retinal capillary plexus (primary objective) will be sought. The study will be carried out on a sample of healthy subjects (control group), which will be compared with individuals with monocular iERM.

End points

  1. Highlight possible differences between groups in the hematic flux retinal/choroidal
  2. Highlight any possible correlations between the retinal/choroidal hematic flow and the morphology of iERM
  3. Identify flow/morphologic/functional parameters, which may represent possible risk factors in normal subjects and/or prognostic factors in patients with iERM
  4. Provide any cut-off values for the flow/functional parameters, calculated with respect to the healthy control values, which represent a risk index for the development of iERM

 

2. Evaluation of tangential movement of the retina in patients undergoing removal of the macular epiretinal membrane

In epiretinal membranes, the OCT examination shows the presence of a hyper-reflective band at the level of the internal retinal surface, which in many cases alters its profile and increases the retinal thicknesses. Recent studies have also shown that the presence of this membrane, during the contraction process that it spontaneously undergoes over time, exerts a tangential traction on the inner retinal layers, causing a translation of the latter with consequent displacement of the retinal vessels that cross them at the macula level. The objective of our study is to evaluate through vessel displacement (12)(13)(14), measured on infrared images of the ocular background, the tangential movements of the inner layers of the retina, and how this process affects visual acuity in eyes subjected to removal of the epiretinal membrane.

The objective of the study is to evaluate the correlation between the displacement of the retinal vessels measured through the distance between the temporal vascular arches and the variation of visual acuity, on eyes with an epiretinal macular membrane before vitrectomy surgery and after 6 months from it.

End points

Evaluate the change in visual acuity after removal of the macular epiretin membrane.

Assess the correlation between the variation in central retinal thickness and changes in visual acuity.

Evaluate through the segmentation of the retinal layers the thickness modifications of the single layers and correlate them with the variation of the visual acuity and with the modification of the distance between the temporal vascular arches.

Evaluate tangential movement of the retina by varying the distance between the vessels of the macular region and the optical disc and correlate it with changes in visual acuity.

 

3. OCT and Microperimetry after vitrectomy 23 gauge for idiopathic macular holes.