Ellipsoid zone reflectivity changes after idiopathic epiretinal membrane peeling: a pilot study

Objective: This pilot study aimed to evaluate changes in ellipsoid zone (EZ) reflectivity and best-corrected visual acuity (BCVA) following epiretinal membrane (ERM) peeling surgery in patients with stage 2 and 3 ERM. Methods: Thirty-five patients with stage 2 and 3 ERM underwent surgical intervention. Preoperative and three-month postoperative measurements of BCVA and EZ reflectivity were taken using spectral-domain optical coherence tomography (SD-OCT). The correlation between changes in BCVA and EZ reflectivity was analyzed. Results: BCVA significantly improved from baseline (0.67 ± 0.23 LogMAR) to three months post-surgery (0.20 ± 0.20 LogMAR) (p < 0.0001). EZ reflectivity also showed a significant increase from baseline (0.62 ± 0.18) to the follow-up visit (0.99 ± 0.30) (p < 0.0001). A significant negative correlation was observed between BCVA (logMAR) and EZ reflectivity (r = - 0.758, p = 0.001). Conclusions: This pilot study provides preliminary evidence that EZ reflectivity correlates with visual recovery after ERM peeling surgery and suggests potential utility as a biomarker for assessing photoreceptor health. Despite the small sample size, the significant correlation between improved BCVA and increased EZ reflectivity warrants further investigation in larger, longitudinal studies.