Vitreopapillary traction in eyes with idiopathic epiretinal membrane: a spectral-domain optical coherence tomography study.

Objective: To investigate the prevalence of vitreopapillary traction (VPT) and its effect on peripapillary structure and visual function in eyes with idiopathic epiretinal membrane (ERM).

Methods: Observational, comparative study. Methods: Patients with idiopathic ERM (n = 116 eyes) and controls with similar age (n = 62 eyes). Methods: Spectral domain optical coherence tomography (SD-OCT) axial optic disc scans were evaluated to identify VPT in eyes with idiopathic ERM. Based on VPT presence/absence, eyes were categorized as ERM with VPT (ERM+VPT, n = 52 eyes) or ERM without VPT (ERM-VPT, n = 64 eyes). Optic nerve head (ONH) parameters, average and sectoral retinal nerve fiber layer (RNFL) thickness, and central macular thickness (CMT) were compared between groups. Best-corrected visual acuity (BCVA) and visual field (VF) (automated Humphrey central 30-2 perimetry) mean deviation (MD) and pattern standard deviation (PSD) were compared between groups. Methods: The ONH parameters, peripapillary RNFL thickness, BCVA, VF MD, and PSD.

Results: Fifty-two of 116 eyes (44.8%) with idiopathic ERM had VPT. The ERM+VPT group had larger rim area, smaller average and vertical cup-to-disc ratios, and smaller cup volume than ERM-VPT and normal groups (all P < 0.001). Eyes with VPT had greater CMT than eyes without VPT (421.87±97.31 μm vs. 377.08±75.1 μm; P = 0.006). Average and temporal RNFL thickness was higher in ERM+VPT (98.64±9.33 μm and 93.90±23.42 μm) than in normal eyes (94.02±8.45 μm and 66.42±12.71 μm). No significant difference in BCVA was found between ERM-VPT and ERM+VPT eyes, but MD was lower in ERM+VPT than in ERM-VPT (-3.91±3.68 dB vs. -2.18±2.42 dB; P = 0.005). Additionally, PSD was greater in ERM+VPT. Multivariate logistic regression analysis revealed that age (odds ratio [OR], 1.190; P = 0.014) and increased CMT (OR, 1.013; P = 0.005) were associated with vision loss, whereas VPT presence was associated with VF defects (OR, 6.290; P = 0.024).

Conclusions: Vitreopapillary traction was observed in >40% of eyes with idiopathic ERM, as confirmed by SD-OCT imaging. Vitreopapillary traction with idiopathic ERM was associated with altered optic disc architecture, increased average and temporal RNFL thickness, and VF defects.