Quantitative analysis of idiopathic epiretinal membrane traction: an updated version of the relaxation index

Purpose The aim of this work was to track tangential traction of idiopathic epiretinal membrane from an initial assessment to the immediate post-operative phase using an enhanced version of the relaxation index (RI). Methods A retrospective analysis was conducted on 9 patients who underwent peeling surgery for idiopathic, symptomatic, and progressive epiretinal membrane. The RI assesses the displacement of vascular crossings in time from a fixed point, which is the retinal pigmented epithelium. This updated iteration integrates infrared images paired with OCT scans instead of OCTA. Results The study encompassed three timepoints: T1 (initial appointment), T2 (1 week pre-surgery), and Post (1 month post-surgery). T1 was 12 +/- 9 months prior to surgery. A statistically significant difference (p<0.001) in RI was observed across all three timepoints; however, there was no significant correlation between RI and visual acuity (p>0.05). Conclusion The RI emerges as a comprehensive and direct parameter for objectively assessing and monitoring tangential traction in three dimensions across an extensive area of the posterior pole. Further streamlining of the process is necessary to integrate this feature into clinical practice effectively.