Purpose: 

To quantify ellipsoid zone (EZ) changes in integrity after epiretinal membrane (ERM) surgery, correlate findings to visual acuity, and determine predictors for prognosis.

Methods: 

A post hoc analysis of eyes undergoing ERM surgery pooled from the prospective DISCOVER intraoperative optical coherence tomography study and eyes undergoing conventional ERM surgery without intraoperative optical coherence tomography. Quantitative EZ features were extracted using a multilayer machine learning enabled automated segmentation platform after image analyst review/correction for segmentation accuracy. Visual acuity and EZ integrity were quantitatively assessed and correlated before and after ERM surgery. Multiple linear regression was performed to assess preoperative visual acuity and EZ features as predictors for improvement in visual acuity or EZ integrity.

Results: 

There were 177 eyes from 177 subjects that underwent ERM surgery from the DISCOVER and conventional arms. Improvement in visual acuity and multiple EZ integrity features was noted after ERM surgery, including EZ partial attenuation and EZ-retinal pigment epithelium (RPE) volume (P < 0.05). A reduction in EZ partial attenuation and increase in EZ-RPE central subfield thickness (EZ-RPE CST) was significantly correlated with improved visual acuity after ERM surgery (P < 0.05). More robust EZ-RPE CST at baseline predicted visual acuity improvement after ERM peel in regression modeling (β = 0.005, P < 0.05).

Conclusions: 

Longitudinal assessment of EZ features demonstrates significant postoperative improvement in multiple EZ integrity metrics after ERM surgery. Improving EZ integrity was correlated to improving the visual acuity. Ellipsoid zone integrity and visual acuity were significant predictors in regression modeling and may have value in clinical prognostication.

中文翻译：

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视网膜前膜手术后的纵向椭圆体区和视网膜外完整性动力学

目的： 

量化视网膜前膜 (ERM) 手术后椭圆体区 (EZ) 完整性的变化，将结果与视力相关联，并确定预后的预测因子。

方法： 

从前瞻性 DISCOVER 术中光学相干断层扫描研究中汇总了接受 ERM 手术的眼睛和接受常规 ERM 手术但没有术中光学相干断层扫描的眼睛的事后分析。在图像分析师审查/校正分割精度后，使用启用多层机器学习的自动分割平台提取定量 EZ 特征。在 ERM 手术前后对视力和 EZ 完整性进行了定量评估和关联。进行多元线性回归以评估术前视力和 EZ 特征作为改善视力或 EZ 完整性的预测因子。

结果： 

来自 177 名受试者的 177 只眼睛接受了 DISCOVER 和常规臂的 ERM 手术。ERM 手术后观察到视力和多个 EZ 完整性特征的改善，包括 EZ 部分衰减和 EZ-视网膜色素上皮 (RPE) 体积 ( P < 0.05)。EZ 部分衰减的减少和 EZ-RPE 中心亚区厚度 (EZ-RPE CST) 的增加与 ERM 手术后视力的改善显着相关（P < 0.05）。在回归模型中，ERM 剥离后基线时更稳健的 EZ-RPE CST 预测视力改善（β = 0.005，P < 0.05）。

结论： 

EZ 特征的纵向评估表明 ERM 手术后多个 EZ 完整性指标的术后显着改善。改善 EZ 完整性与改善视力相关。椭球区完整性和视力是回归模型中的重要预测因子，可能在临床预后中具有价值。