Assessment of microcystoid macular edema in postoperative epiretinal membrane using adaptive optics scanning laser ophthalmoscopy and swept-source optical coherence tomography: a pilot study.

Abstract

To characterize multimodal imaging features and potential mechanisms of microcystoid macular edema (MME) in epiretinal membrane (ERM), and explore postoperative heterogeneity in retinal structure and visual recovery. This pilot study included patients with idiopathic ERM postoperatively. Patients were categorized into MME and non-MME (NMME) groups based on postoperative SS-OCT findings. Postoperative multimodal retinal imaging features were detected using adaptive optics scanning laser ophthalmoscopy (AO-SLO) and swept-source optical coherence tomography (SS-OCT) and compared between the two groups. A total of 40 eyes of 40 patients were enrolled in the current study. There was no significant difference in baseline characteristics between the two group (All P > 0.050). AO-SLO revealed microcysts, waxy membranes, hyperreflective foci, hyporeflective zones, and microfolds. Dissociated optic nerve fiber layer was observed in 29 eyes (72.5%), comprising 17 eyes in the NMME group and 12 eyes in the MME group (P = 0.279). Compared with the NMME group, the MME group showed increased central retinal thickness (P = 0.016), inner nuclear layer thickness (P = 0.016), and vessel density in the deep vascular complex (P = 0.029), along with thinner retinal nerve fiber layer (P = 0.019). Postoperative MME in ERM may be associated with ERM-induced traction, Müller cell dysfunction, and remodeling of retinal structure and microcirculation. In this pilot study, the presence of postoperative MME may reflect a distinct pattern of biological injury and recovery in ERM. AO-SLO and SS-OCT provide insights into biological heterogeneity, aiding personalized postoperative evaluation.