Retinal Dot Hemorrhage during Epiretinal Membrane Peeling

1. Hyun Jun Park¹
2. Ji Hun Kim²
3. Ik Su Byeon²
4. Ji Eun Lee^2,3
5. Boo Sup Oum^2,3
6. Hee Young Choi^2,3

¹Department of Ophthalmology, Pusan National University Yangsan Hospital, Busan, Korea1
²Department of Ophthalmology, Pusan National University Hospital, Busan, Korea2
³Medical Research Institute, Pusan National University, Busan, Korea3

Purpose: To evaluate the relationship between retinal dot hemorrhage that occurred during epiretinal membrane peeling (MP) and the damage to internal limiting membrane (ILM) at idiopathic epiretinal membrane (ERM).

Methods: We retrospectively studied 29 eyes of 29 consecutive patients who underwent vitrectomy with MP for idiopathic ERM. For all the patients, ILM was stained with indocyanine green following MP. After evaluating that ILM damage occurred, the stained, remaining ILM peeled additionally. It was also investigated whether or not retinal hemorrhage occurred during MP and where the hemorrhage occurred.

Results: Retinal dot hemorrhage occurred during MP in 21 eyes, while it did not occur in 8 eyes. Among 21 eyes with retinal hemorrhage, the hemorrhage was located at the site where ILM peeled in 18 eyes and where ERM peeled although ERM and ILM peeled simultaneously in 1 eye, and the hemorrhage occurred in 2 eyes although only ERM peeled. Among 8 eyes without retinal hemorrhage, a part of ILM was damaged in 4 eyes, while ILM remained intact in 4 eyes. The number of cases where both ERM and ILM peeled simultaneously was significantly higher among the cases retinal hemorrhage occurred (p=0.031).

Conclusions: It can be assumed that ILM is damaged at the hemorrhage site if retinal dot hemorrhage occurred during MP at idiopathic ERM.