Surface-Specific Internal Limiting Membrane Biomechanics in Epiretinal Membrane Severity and Visual Outcomes.
5 affiliations
- 1Department of Mechanical Engineering, Korea University, Seoul, Republic of Korea.
- 2Veterans Health Service Medical Center, Seoul, Republic of Korea.
- 3Laboratory of Cell Imaging, Seoul Shinsegae Eye Center, Seoul, Republic of Korea.
- 4Department of Ophthalmology, Seoul Shinsegae Eye Center, Uijeongbu, Gyeonggi-do, Republic of Korea.
- 5Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea.
Abstract
Purpose
To determine whether surface-specific biophysical properties of the internal limiting membrane (ILM), measured by atomic force microscopy (AFM), are associated with optical coherence tomography (OCT)-based epiretinal membrane (ERM) stage and six-month visual outcomes.Methods
In this prospective study, ILM specimens from vitrectomy for idiopathic ERM (stages 2-4) were examined by AFM for thickness, roughness, stiffness, and adhesion on the vitreal or retinal surface. AFM parameters were related to preoperative OCT parameters, best-corrected visual acuity, surgical grade of ILM adherence, and six-month outcomes. Multivariable regression assessed correlates of visual change and final acuity.Results
We analyzed 147 eyes (80 retinal-side, 67 vitreal-side). Retinal-side roughness and stiffness exceeded vitreal-side values (both P < 0.001). Retinal-side roughness and adhesion (P < 0.001 and P = 0.008, respectively) and, less strongly, vitreal-side stiffness (P = 0.035) increased with ERM stage, whereas vitreal-side adhesion did not. Thickness did not differ by surface or stage (all P ≥ 0.116). Retinal-side roughness and adhesion correlated with preoperative severity and postoperative outcomes, whereas vitreal-side stiffness correlated mainly with severity and vitreal-side adhesion with surgical adherence. Greater retinal-side adhesion and vitreal-side stiffness were associated with smaller visual gains and worse final acuity in multivariable models (all P < 0.05).Conclusions
ILM biophysical properties showed surface-specific associations with OCT-based ERM severity and six-month visual outcomes. Retinal-side adhesion and vitreal-side stiffness remained associated with final acuity after adjustment for baseline acuity. These findings suggest that ILM surface mechanics may reflect ERM-related retinal deformation relevant to postoperative visual recovery.
Related
- Inverted epiretinal proliferation flap with internal limiting membrane preservation for myopic macular hole retinal detachment: a case report
- Effect of Internal Limiting Membrane Peeling on Macular and Optic Disc Vascular Density Following Epiretinal Membrane Surgery.
- Viscoelastic-Assisted Rescue of Unintended Free Internal Limiting Membrane Flaps During Macular Hole Surgery: A Two-Case Report
- Correlation Between Central Macular Thickness and Visual Acuity After Vitrectomy and Internal Limiting Membrane Peeling
- Temporal inverted internal limiting membrane flap technique for a 500 μm full-thickness macular hole : A case report
BibTeX
@article{yoon2026surfacespecific,
title = {{Surface-Specific Internal Limiting Membrane Biomechanics in Epiretinal Membrane Severity and Visual Outcomes.}},
author = {Changsik Yoon and Sangkyung Choi and Yeseul Yoon and Gi Young Kong and Byung Gil Moon and Byung Yang Lee and Hyun Seung Yang},
journal = {Investigative ophthalmology \& visual science},
year = {2026},
month = oct,
doi = {10.1167/iovs.67.12.14},
url = {https://europepmc.org/article/MED/42841589},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Surface-Specific Internal Limiting Membrane Biomechanics in Epiretinal Membrane Severity and Visual Outcomes.
AU - Changsik Yoon
AU - Sangkyung Choi
AU - Yeseul Yoon
AU - Gi Young Kong
AU - Byung Gil Moon
AU - Byung Yang Lee
AU - Hyun Seung Yang
PY - 2026
DA - 2026/10/01
JO - Investigative ophthalmology & visual science
DO - 10.1167/iovs.67.12.14
UR - https://europepmc.org/article/MED/42841589
AB - Purpose To determine whether surface-specific biophysical properties of the internal limiting membrane (ILM), measured by atomic force microscopy (AFM), are associated with optical coherence tomography (OCT)-based epiretinal membrane (ERM) stage and six-month visual outcomes.Methods In this prospective study, ILM specimens from vitrectomy for idiopathic ERM (stages 2-4) were examined by AFM for thickness, roughness, stiffness, and adhesion on the vitreal or retinal surface. AFM parameters were related to preoperative OCT parameters, best-corrected visual acuity, surgical grade of ILM adherence, and six-month outcomes. Multivariable regression assessed correlates of visual change and final acuity.Results We analyzed 147 eyes (80 retinal-side, 67 vitreal-side). Retinal-side roughness and stiffness exceeded vitreal-side values (both P < 0.001). Retinal-side roughness and adhesion (P < 0.001 and P = 0.008, respectively) and, less strongly, vitreal-side stiffness (P = 0.035) increased with ERM stage, whereas vitreal-side adhesion did not. Thickness did not differ by surface or stage (all P ≥ 0.116). Retinal-side roughness and adhesion correlated with preoperative severity and postoperative outcomes, whereas vitreal-side stiffness correlated mainly with severity and vitreal-side adhesion with surgical adherence. Greater retinal-side adhesion and vitreal-side stiffness were associated with smaller visual gains and worse final acuity in multivariable models (all P < 0.05).Conclusions ILM biophysical properties showed surface-specific associations with OCT-based ERM severity and six-month visual outcomes. Retinal-side adhesion and vitreal-side stiffness remained associated with final acuity after adjustment for baseline acuity. These findings suggest that ILM surface mechanics may reflect ERM-related retinal deformation relevant to postoperative visual recovery.
SN - 0146-0404
SN - 1552-5783
ER -