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Retinal vascular arcade angle as a biomarker for visual improvement after epiretinal membrane surgery

Eye volume 38, pages 778–785 (2024)Cite this article

Subjects

Abstract

Objectives

To investigate the changes in the temporal vascular angles after epiretinal membrane (ERM) surgery and utilize the angles to predict visual outcomes.

Methods

A total of 168 eyes from 84 patients with unilateral ERM who underwent vitrectomy were enrolled from a single institution. The angles of temporal venous (anglevein) and arterial arcades (angleartery) were measured on fundus photographs. The relationships between the angles and the best-corrected visual acuity (BCVA) were explored and multivariable logistic models and receiver operating characteristic (ROC) curves were analyzed to identify the factors that predicted visual outcomes.

Results

At baseline, both angleartery and anglevein were narrower in the eyes with ERM than the fellow eyes (p < 0.001 and 0.007) but had no correlation with the baseline BCVA (p = 0.754 and 0.804). Postoperatively, the angleartery and anglevein significantly widened (both p < 0.001) and a greater BCVA improvement was associated with a greater widening of the angleartery (p = 0.029) and anglevein (p = 0.050). Multivariable logistic analyses found a narrower baseline angleartery compared to the fellow eye had a higher chance for BCVA improvement ≧ 2 lines (Odds ratio = 0.97; 95% CI, 0.94–0.99; p = 0.016). ROC curve showed the baseline difference in the angleartery between bilateral eyes predicted BCVA improvement ≧ 2 lines (area under the curve = 0.74; p = 0.035), and a 0.73 sensitivity and 0.80 specificity with a cut-off value of −27.19 degrees.

Conclusions

The retinal vascular angles widened after ERM surgery and the fundus photograph-derived angles may serve as a highly-accessible biomarker to predict postoperative visual outcomes.

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Fig. 1: Definition and measurement of temporal retinal vascular angle.

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Data availability

Data supporting the findings of the current study are available from the corresponding author on reasonable request.

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Author information

Author notes

  1. These authors contributed equally: Hung-Da Chou, Yu-Chieh Chang.

Authors and Affiliations

  1. Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan

    Hung-Da Chou, Eugene Yu-Chuan Kang, Yi-Hsing Chen, Laura Liu, Kuan-Jen Chen, Yih-Shiou Hwang, An-Ning Chao & Wei-Chi Wu

  2. College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Hung-Da Chou, Eugene Yu-Chuan Kang, Yi-Hsing Chen, Laura Liu, Kuan-Jen Chen, Yih-Shiou Hwang, An-Ning Chao, Wei-Chi Wu & Chi-Chun Lai

  3. Department of Medical Education, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan

    Yu-Chieh Chang & Po-Yi Wu

  4. Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan

    Chi-Chun Lai

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Contributions

HDC, YCC: writing the manuscript, analysing the results, and interpreting the data. EYCK, YHC, LL, KJC, YSH, ANC, WCW, CCL: data collection. HDC, YCC, PYW: data processing. HDC, YCC: conception and design of the work. All authors approved the final manuscript.

Corresponding author

Correspondence to Chi-Chun Lai.

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Chou, HD., Chang, YC., Wu, PY. et al. Retinal vascular arcade angle as a biomarker for visual improvement after epiretinal membrane surgery. Eye 38, 778–785 (2024). https://doi.org/10.1038/s41433-023-02776-6

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