Perfusion Capacity as a Predictive Index for Assessing Visual Functional Recovery in Patients With Idiopathic Epiretinal Membrane.

Purpose: This study investigates the association between visual function and retinal vasculature metrics, particularly perfusion capacity (PC), in eyes with idiopathic epiretinal membrane (iERM), using optical coherence tomography angiography (OCTA).

Methods: This retrospective study includes 30 eyes from 30 iERM patients who had surgery, with a three-month follow-up period. In addition, 28 eyes from 28 healthy individuals served as a control group. We measured best-corrected visual acuity (BCVA), retinal sensitivity, vascular density (VD), perfusion area (PA), PC, and retinal thickness (RT). OCTA scans assessed both the superficial vascular complex (SVC) and deep vascular complex (DVC) in 3 × 3 mm2 and 6 × 6 mm2 regions. Associations between retinal vasculature metrics and visual outcomes were analyzed.

Results: Postoperatively, significant improvements were observed in both BCVA and retinal sensitivity (both P < 0.001). In the SVC layer, VD and PA were significantly decreased (both P < 0.001), whereas PC in the SVC increased significantly (P < 0.001). Higher preoperative PC in the SVC was associated with greater postoperative improvements in retinal sensitivity. Postoperative retinal sensitivity was negatively associated with age (β = -0.53, P = 0.001) and retinal thickness in 3 × 3 mm2 region (β = -0.39, P = 0.013) but positively associated with preoperative retinal sensitivity (β = 1.10, P < 0.001) and PC in the SVC within 3 × 3 mm2 region (β = 0.49, P = 0.023).

Conclusions: PC offers a novel approach to evaluating retinal microcirculation and visual prognosis in iERM. Preoperative PC in the SVC serves as a reliable predictive index for predicting postoperative visual recovery.

Translational relevance: The PC, as a novel indicator of retinal blood flow, not only reflects the condition of the blood vessels but is also associated with retinal sensitivity.