Vascular tortuosity analysis in eyes with epiretinal membrane imaged by optical coherence tomography angiography

<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>This study aimed to evaluate macular vessel tortuosity using optical coherence tomography angiography (OCTA) and its association with visual outcomes in eyes undergoing surgery for epiretinal membrane (ERM).</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>The study included 22 consecutive patients who underwent vitrectomy for ERM between May 2019 and July 2020 and OCTA at Osaka University Hospital. All patients underwent ophthalmologic examinations, including swept-source OCTA. Standard vitrectomy was performed, and the patients were followed up for 6 months postoperatively. Distortion of retinal vessels was calculated using two parameters: the actual vessel length in the vessel section (VL) and the direct vessel branching point distance (BD) in the three quadrants (nasal, temporal, and superior-inferior) of the macula. We analyzed the correlation between these parameters and visual outcomes.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Significantly longer VL was found at 1, 3, and 6 months postoperatively (<jats:italic>p</jats:italic> = 0.006, 0.008, and 0.022, respectively) in the temporal quadrant compared to baseline temporal VL. Significantly shorter VL was found in nasal quadrants at 1 and 3 months (<jats:italic>p</jats:italic> = 0.046 and <jats:italic>p</jats:italic> = 0.018) in the comparison of nasal baseline VL. VL/BDs were correlated with the same postoperative best-corrected visual acuity (BCVA) at 1, 3, and 6 months (<jats:italic>p</jats:italic> = 0.035, 0.035, and 0.042, respectively) in the superior-inferior quadrant. A significant association of changes in VL and BCVA was found at 3 and 6 months postoperatively in the nasal quadrant (<jats:italic>p</jats:italic> = 0.018 and 0.0455, respectively).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Changes in vascular distortion after ERM surgery can be measured using OCTA. The change in vessels around the macula became more linear; this was associated with visual outcomes after surgery.</jats:p> </jats:sec>