Cone and retinal microvasculature distribution characteristics with idiopathic epiretinal membrane

Jiang Wu; Ye Xin; Xiangpeng Zhou; Shucheng He; Yingjiao Shen; Lijun Shen

doi:10.3760/cma.j.cn115989-20250613-00200

Cone and retinal microvasculature distribution characteristics with idiopathic epiretinal membrane

July 22, 2026

2026，No. 07, Clinical Science, Current Issue, Highlights

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Authors:Wu Jiang, Ye Xin, Zhou Xiangpeng, He Shucheng, Shen Yingjiao, Shen Lijun

Corresponding author:Shen Lijun, Email:slj@mail.eye.ac.cn

Published:2026-07-10

DOI:10.3760/cma.j.cn115989-20250613-00200

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ABSTRACT

Objective To investigate cone density and retinal microvascular distribution characteristics in idiopathic epiretinal membrane (IERM) by utilizing multimodal imaging techniques.

Methods A self-controlled study was conducted. Twenty-eight patients (56 eyes) with unilateral IERM diagnosed at the Department of Ophthalmology, Zhejiang Provincial People’s Hospital from November 2023 to April 2025 were enrolled. Patients’ best-corrected visual acuity (BCVA) was recorded. Cone density in the 2.4 mm×2.4 mm macular area was quantitatively measured using confocal scanning laser ophthalmoscopy (CSLO). The vascular density in both the superficial vascular complex (SVC) and deep vascular complexes (DVC), along with the foveal avascular zone (FAZ) area and perimeter within the 6 mm×6 mm macular region, were assessed by optical coherence tomography angiography (OCTA). Visual acuity, cone density, and retinal microvascular parameters were compared between the IERM group and the fellow-eye group. The correlations between each variable and the mean macular cone density were analyzed. This study complied with the Declaration of Helsinki. The study protocol was approved by the Ethics Review Committee of Zhejiang Provincial People’s Hospital (No. KY2024038). Informed consent was obtained from all participants before undergoing any examination.

Results The BCVA (logMAR) in the IERM group was 0.40 (0.30, 0.52), which was significantly poorer than 0.10 (0.00, 0.20) in the fellow-eye group, showing a statistically significant difference ( Z=-4.546, P<0.001). The mean cone densities in the macular region, superotemporal, inferotemporal, superonasal, and inferonasal regions in the IERM group were significantly higher than those in the fellow-eye group ( t=5.453, 5.272, 4.815, 5.959, 5.698; all P<0.001). The SVC vascular density in the IERM group was significantly higher than that in the fellow-eye group, while the FAZ area and perimeter were significantly lower, and the differences were statistically significant ( t=2.300, -3.465, -2.729, all P<0.05). No significant difference was observed in DVC vascular density between the two groups ( t=-1.898, P=0.123). Correlation analysis showed that the mean macular cone density was positively correlated with BCVA ( r _s=0.363, P=0.006) and negatively correlated with FAZ area ( r=-0.297, P=0.048), but was not significantly correlated with SVC vascular density, DVC vascular density, or FAZ perimeter ( r=-0.003, -0.216, -0.197; all P>0.05) in IERM eyes.

Conclusions In IERM eyes, cone density and SVC vascular density are increased, FAZ area is decreased, and cone density is negatively correlated with FAZ area. CSLO combined with OCTA may facilitate a comprehensive evaluation of retinal microstructure.

KEYWORDS：

Epiretinal membrane;Fovea centralis;Cone density;Retinal microvasculature;Confocal scanning laser ophthalmoscopy

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