Clinical and morphological evaluation of surgical treatment of idiopathic epiretinal membranes in patients with initial signs of pathological process

Abstract

Surgical removal of the epiretinal membrane (ERM) remains an effective method in elimination of the traction effect on the retina. But it is not always possible to achieve high functional results in the postoperative period. Therefore, the question on a determination for the period of surgical treatment with the identification of morphological elements of ERM and a confirmation of the progression of the proliferative process in the early stages of its formation remains relevant.Purpose. To justify and evaluate the efficacy of the tactics in early surgical treatment of idiopathic ERM (iERM) in patients with high visual acuity.Material and methods. A morphofunctional assessment of early surgical treatment of idiopathic ERM was performed in 30 patients (30 eyes). It was consisted in a dynamic monitoring of the best corrected visual acuity (BCVA), the data of optical coherence tomography. Immunohistochemical examination of epiretinal membrane samples revealed and visualized the following antigens: glial fibrillar protein (GFAP), TGF-β1, α-SM actin, cellular retinaldehyde-binding protein (CRALBP), fibronectin, CD68, CD45, and collagen types II, IV, VI.Results. A statistically significant difference between preoperative visual acuity and visual acuity at different postoperative follow-up periods was revealed (p<0.05). The immune-histochemical study mainly determined the expression of GFAP, CRALBP and vimentin.Conclusions. The performed analysis of clinical and functional results in the surgical treatment of iERM in patients with high best-corrected visual acuity confirmed the efficiency in the early surgical treatment of this pathology.

Keywords

• surgical treatment
• proliferative process
• epiretinal membrane
• hyalocytes
• muller cells
• myofibroblast-like cells