ArticleEye (London, England)2026
Morphological plasticity and visual acuity in the natural course of epiretinal membrane-foveoschisis: A longitudinal OCT study.
Article in Eye (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo characterise the natural course of epiretinal membrane-foveoschisis (ERM-F) using optical coherence tomography (OCT) and analyse morphological and visual changes.
methodsRetrospective single-centre study of treatment-naïve idiopathic ERM-F eyes. Functional and morphological changes from baseline to the final visit were assessed. The primary outcome was change in best-corrected visual acuity (BCVA). Secondary outcomes included subtype transitions, progression to lamellar macular hole (LMH) or mixed ERM-F/LMH.
resultsA total of 124 eyes from 113 patients (mean age 67.9 ± 8.0 years) were followed for 58.8 ± 47.4 months. Mean BCVA remained stable (baseline: 0.16 ± 0.15 logMAR; final: 0.18 ± 0.15 logMAR; p = 0.29). Baseline ERM-F subtypes were open-flat (61.3%), open-elevated (24.2%), and closed (14.5%), shifting to 46.8%, 28.2%, and 9.7%, respectively, at the final visit. Conversion to mixed ERM-F/LMH and LMH occurred in 11.3% and 2.4% of eyes, respectively; two eyes (1.6%) developed a normal foveal contour, while two eyes progressed from open-flat ERM-F via mixed ERM-F/LMH phenotype to full-thickness macular hole. Central foveal thickness (CFT) did not change significantly (p = 0.457). Structural changes included increased foveal wall verticalisation and emergence of subfoveal EZ disruption, undermined edges, retinal tissue loss, and foveal bump in a subset of patients. Subfoveal EZ disruption was associated with worse final BCVA on univariable analysis, but not after multivariable adjustment for baseline BCVA and cataract surgery.
conclusionERM-F shows morphological plasticity with generally stable visual outcomes. A minority of eyes progress to mixed ERM-F/LMH or LMH.
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