Anatomical and functional changes in paravascular abnormalities after epiretinal membrane removal

  • Tatsuhiko SatoEmail author
  • Reina Mori
  • Shinya Takahashi
  • Koichi Yoshimura
  • Akira Hirata
  • Shin-ichi Manabe
  • Ken Hayashi
Retinal Disorders



To investigate the anatomical and functional changes in areas containing paravascular abnormalities (PVA) in eyes with epiretinal membrane (ERM) after surgery.


Twenty-eight eyes with concurrent idiopathic ERM and PVA were enrolled in this prospective study. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and areas of PVA in the superficial and deep capillary levels detected on en face optical coherence tomography were measured preoperatively and 1, 3, and 6 months postoperatively. Retinal sensitivity in selected PVA lesions was evaluated by microperimetry preoperatively and 1 and 6 months postoperatively.


The areas of PVA at the superficial capillary level before and 1, 3, and 6 months after surgery measured 1.65 ± 1.27, 0.44 ± 0.62, 0.40 ± 0.64, and 0.38 ± 0.62 mm2, respectively, while those at the deep capillary level measured 0.27 ± 0.57, 0.10 ± 0.26, 0.09 ± 0.29, and 0.05 ± 0.15 mm2, respectively. The areas of PVA in the superficial and deep capillary levels were significantly smaller postoperatively (all p < 0.001 at the superficial capillary level and p = 0.010 at the deep capillary level). Average retinal sensitivity values in the PVA lesions before and 1 and 6 months after surgery were 11.2 ± 3.5, 12.9 ± 3.2, and 13.2 ± 2.7 dB, respectively; the values at postoperative months 1 and 6 were significantly improved (p = 0.045 and p < 0.001, respectively). BCVA and CMT were significantly improved postoperatively.


PVA not only improves anatomically but also functionally after ERM surgery. Vitrectomy can improve not only central vision but also retinal sensitivity in areas of PVA.


Epiretinal membrane Microperimetry Optical coherence tomography Paravascular abnormality Vitrectomy 



The authors thank Koji Yonemoto, PhD, for statistical assistance.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Hayashi Eye Hospital institutional review committee and with the 1964 Helsinki Declaration.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

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Supplementary Fig 1.

En face images in eyes with concurrent epiretinal membrane and paravascular abnormalities obtained using swept-source optical coherence tomography (PLEX® Elite 9000, Carl Zeiss Meditec, Inc., Dublin, CA, USA). Spindle-shaped or caterpillar track-shaped black retinal lesions were detected adjacent to major retinal vessels. BCVA, best-corrected visual acuity; AL, axial length. (PNG 4753 kb)

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High resolution image (TIF 8817 kb)
417_2019_4376_Fig6_ESM.png (493 kb)
Supplementary Fig 2.

MP1 microperimetry in a patient with epiretinal membrane and paravascular abnormalities (PVA). (A). First, a 30-second fixation test was performed. (B). An en face image in the superficial capillary level acquired by Cirrus™ optical coherence tomography with AngioPlex®. Spindle-shaped or caterpillar track-shaped black retinal lesions were detected adjacent to the major retinal vessels. A red circle indicates the PVA lesion in which MP1 microperimetry was performed. (C). After the fixation test, microperimetry was performed using a customized 33-loci stimuli covering selected areas of PVA. (D). A magnified image from (C) showing the retinal sensitivity at each locus. The mean retinal sensitivity was 12.2 dB. (PNG 492 kb)

417_2019_4376_MOESM2_ESM.tif (6.1 mb)
High resolution image (TIF 6222 kb)


  1. 1.
    Liu HY, Hsieh YT, Yang CM (2016) Paravascular abnormalities in eyes with idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 254:1723–1729. CrossRefGoogle Scholar
  2. 2.
    Shimada N, Ohno-Matsui K, Nishimuta A, Moriyama M, Yoshida T, Tokoro T, Mochizuki M (2008) Detection of paravascular lamellar holes and other paravascular abnormalities by optical coherence tomography in eyes with high myopia. Ophthalmology 115:708–717. CrossRefGoogle Scholar
  3. 3.
    Muraoka Y, Tsujikawa A, Hata M, Yamashiro K, Ellabban AA, Takahashi A, Nakanishi H, Ooto S, Tanabe T, Yoshimura N (2015) Paravascular inner retinal defect associated with high myopia or epiretinal membrane. JAMA Ophthalmol 133:413–420. CrossRefGoogle Scholar
  4. 4.
    Miyoshi Y, Tsujikawa A, Manabe S, Nakano Y, Fujita T, Shiragami C, Hirooka K, Uji A, Muraoka Y (2016) Prevalence, characteristics, and pathogenesis of paravascular inner retinal defects associated with epiretinal membranes. Graefes Arch Clin Exp Ophthalmol 254:1941–1949. CrossRefGoogle Scholar
  5. 5.
    Chihara E, Chihara K (1992) Apparent cleavage of the retinal nerve fiber layer in asymptomatic eyes with high myopia. Graefes Arch Clin Exp Ophthalmol 230:416–420CrossRefGoogle Scholar
  6. 6.
    Komeima K, Kikuchi M, Ito Y, Terasaki H, Miyake Y (2005) Paravascular inner retinal cleavage in a highly myopic eye. Arch Ophthalmol 123:1449–1450. CrossRefGoogle Scholar
  7. 7.
    Chihara E (2015) Myopic cleavage of retinal nerve fiber layer assessed by split-spectrum amplitude-decorrelation angiography optical coherence tomography. JAMA Ophthalmol 133:e152143. CrossRefGoogle Scholar
  8. 8.
    Hwang YH, Kim YY, Kim HK, Sohn YH (2015) Characteristics of eyes with inner retinal cleavage. Graefes Arch Clin Exp Ophthalmol 253:215–220. CrossRefGoogle Scholar
  9. 9.
    Midena E, Vujosevic S, Cavarzeran F, Microperimetry Study Group (2010) Normal values for fundus perimetry with the microperimeter MP1. Ophthalmology 117:1571–1576, 1576.e1. CrossRefGoogle Scholar
  10. 10.
    Julious SA (2005) Sample size of 12 per group rule of thumb for a pilot study. Pharm Stat 4:287–291. CrossRefGoogle Scholar
  11. 11.
    Ogura Y, Takanashi T, Ishigooka H, Ogino N (1991) Quantitative analysis of lens changes after vitrectomy by fluorophotometry. Am J Ophthalmol 111:179–183CrossRefGoogle Scholar
  12. 12.
    Melberg NS, Thomas MA (1995) Nuclear sclerotic cataract after vitrectomy in patients younger than 50 years of age. Ophthalmology 102:1466–1471CrossRefGoogle Scholar
  13. 13.
    Enaida H, Hisatomi T, Hata Y, Ueno A, Goto Y, Yamada T, Kubota T, Ishibashi T (2006) Brilliant blue G selectively stains the internal limiting membrane/brilliant blue G-assisted membrane peeling. Retina 26:631–636. Google Scholar
  14. 14.
    Yanagisawa M, Murata H, Matsuura M, Fujino Y, Hirasawa K, Asaoka R (2017) Goldmann V standard automated perimetry underestimates central visual sensitivity in glaucomatous eyes with increased axial length. Transl Vis Sci Technol 6:13. CrossRefGoogle Scholar
  15. 15.
    Anderson DR (1987) Perimetry with and without automation, 2nd edn. CV Mosby, St LouisGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Hayashi Eye HospitalFukuokaJapan

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