Correlation between new OCT parameters and metamorphopsia in advanced stages of epiretinal membranes

Purpose To correlate metamorphopsia provided by M-CHARTS and ectopic inner foveal layers (EIFL) or 'central bouquet' abnormality (CBA) in patients with advanced stages of epiretinal membrane (ERM) following the novel Optical Coherence Tomography (OCT)-based grading scheme. Methods In 60 eyes of 57 patients affected by ERM (stages 3 and 4), the degree of metamorphopsia using the M-CHARTS was evaluated (M-SCORE) and correlated with EIFL, CBA and central foveal thickness (CFT) as measured on OCT scans. Results A total of 37 and 23 eyes were diagnosed having ERM stages 3 and 4, respectively. Mean vertical and horizontal M-SCORE (M-V and M-H) were 0.64 +/- 0.43 and 0.58 +/- 0.37 standard deviations, respectively. Mean M-SCORE exhibited a statistically significant correlation with EIFL and CFT (both p < 0.0001), but not with CBA (p = 0.84). Analysing the direction of metamorphopsia separately, M-H and M-V were significantly correlated with EIFL (both p < 0.0001), but not with CBA thickness (p = 0.70 and 0.33 respectively). Ectopic inner foveal layers (EIFL) was significantly influenced by the presence of CBA (CBA present, 158.29 +/- 63.53 micron; CBA absent, 107.05 +/- 94.13 micron, p = 0.04). No significant differences were found for both M-V and M-H with respect to the presence of CBA. Conclusions Based on the novel OCT-based grading scheme for ERMs, our results demonstrate that EIFL, but not CBA, might be considered a good indicator for metamorphopsia in patients with advanced ERMs.