Retinal sensitivity and optical coherence tomography findings in eyes with idiopathic epiretinal membrane
Bibliographic record
Abstract
Editor, Idiopathic epiretinal membrane (ERM) is a common eye disease. In practice, its functional impact is evaluated by measurement of best-corrected visual acuity (BCVA) and presence of metamorphopsia. Macular function may also be studied using microperimetry (Rohrschneider et al. 2008). The objective of this study was to analyse macular function by measuring its sensitivity using microperimetry in patients with idiopathic ERM and to correlate it to the BCVA and spectral-domain optical coherence tomography (SD-OCT) findings. We prospectively included 49 eyes of 49 consecutive patients with idiopathic ERM for which surgical treatment had been planned. We excluded patients with secondary ERM, severe media opacities, macular degeneration or other eye diseases that could influence VA. We considered as a control group 27 eyes of 27 patients with a normal BCVA (>78 letters) and a normal macular OCT profile. All patients had BCVA measured at 4 m with the standard Early Treatment Diabetic Retinopathy Study (ETDRS) chart (Precision Vision, La Salle, IL, USA), a slit-lamp examination and a dilated fundus ophthalmoscopy. Additional tests performed were microperimetry and macular OCT using OPKO/OTI (OPKO/Ophthalmic Technologies Inc., Toronto, ON, Canada). The topographic map and a macular sensitivity map were centred on the fovea and superimposed. For the evaluation of subtle retinal changes, a macular OCT using HRA-OCT (Heidelberg Engineering, Heidelberg, Germany) was performed. For microperimetry, we used the Polar 3 testing pattern, a Goldmann III stimulus, a 200-ms presentation time and a 4-2-1 staircase strategy. Polar 3 is a standardized grid composed of 28 dots arranged in three concentric circles (2.3°, 6.6° and 11° in diameter) within the central macula. The mean macular sensitivities (MS), central circle or foveal sensitivities (FS) and stability of fixation were recorded. The general characteristics of the patients are displayed in the Table 1. The BCVA, FS and MS were significantly lower (p = 0.0001), and foveal and macular thickness (FT, MT) and foveal and macular volume (FV, MV) were significantly higher (p = 0.0001) in eyes with ERM compared with control eyes (Table 1). In eyes with ERM, we found a significant correlation between retinal sensitivity (MS, FS) and BCVA (r = 0.563, p =0.0005 and r = 0.435, p = 0.038, respectively). A negative correlation was found between MS and MT (r = −0.441, p = 0.032). In the ERM group, patients with stable macular fixation (83.7%) had a significantly higher MS and BCVA than those with relatively unstable fixation (16.3%), (p = 0.003 and p =0.003, respectively). In the control group, only one patient had relatively unstable fixation (3.7%). Eyes with an abnormal inner/outer photoreceptor segment (IS/OS) junction (18.4%) and those with a disorganized retinal outer layer (36.7%) had significantly lower MS than eyes without these lesions in the ERM group (p = 0.001 and p = 0.007, respectively). Lower BCVA was associated with IS/OS junction abnormalities (p = 0.008). There are contradictory opinions on the influence of macular thickening on macular function, and few other studies have used microperimetry to evaluate macular function in ERM. Karacorlu et al. (2010) found similar results. Conversely, Pilli et al. (2011) found no relationship between sensitivity and MT, but they also included asymptomatic eyes. Moreover, it was shown that photoreceptor defects may be an important prognostic factor in patients with ERM (Kim et al. 2012; Shimozono et al. 2012). Microperimetry is complementary to VA measurement and OCT in the evaluation of eyes with ERM. We are conducting a longitudinal study to evaluate the changes in microperimetry and OCT findings after surgical treatment of ERM.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".