Surgical Treatment And Postoperative Fixation Characteristics Of The Macular Epiretinal Membrane In Young Patients

Objects: To describe postoperative visual outcomes and use micromerimetry to analysis postoperative fixation characteristics of the macular epiretinal membrane(ERM)in young subjects,then have correlation analysis with Best Corrected Visual Acutiy.Methods: Retrospective observational cohort study.In all,41 consecutive subjects(43 eyes)aged 0.8 to 16 years,including 28 subjects(29 eyes)with secondary macular ERMs(group 1)and 13 subjects(14 eyes)with idiopathic macular ERMs(group 2).All 43 eyes underwent 25 gauge vitrectomy and membrane peeling by the same retinal surgeon.Twenty patients(12 in group 1 and 8 in group 2)were assessed for fixation characteristics using the MAIA microperimetry instrument(CenterVue,Padova,Italy)postoperatively(6–49 months).Three(one in group 1 and two in group 2)patients received MAIA examination,both pre-and postoperatively(6 months).Results: For group 1,best-corrected visual acuity(BCVA)improved from 1.42 ± 0.67 to 0.97 ± 0.42 logMAR(P = 0.005).For group 2,BCVA improved from 0.87 ± 0.51 to 0.70 ± 0.50 logMAR(P = 0.129).Foveal fixation was found in one(8%)eye in group 1 and five(63%)eyes in group 2(P = 0.018).In group 1,1(8%)eye had stable fixation,1(8%)eye had relatively unstable fixation and 10(84%)eyes had unstable fixation.In group 2,3(38%)eyes had stable fixation and five(62%)eyes had relatively unstable fixation.Postoperative BCVA has line correlation with fixation stability.Conclusion: Young patients with ERMs respond well to membrane peeling,with a low percentage of recurrence and complications.Compared to idiopathic ERM,secondary ERM is charactered by premacular fibrosis and affected vision acuity severely.Postoperative fixation characteristics were unsatisfactory,especially for secondary ERMs.Besides,microperimetry can find subclinical scotoma and help surgeon understand macular function comprehensively.