Retina is the light-sensitive layer of tissue, forming the inner surface of the eye. Epiretinal membrane (ERM) is a semitransparent membrane between vitreous and the internal limiting membrane. Optical coherence tomography (OCT) is a procedure used for diagnosis and follow up of macular disorders. Objective: To determine the changes in the retinal nerve fiber layer thickness after epiretinal membrane peeling in patients with idiopathic epiretinal membrane with the help of optical coherence

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... raphy. Study Design: It was a descriptive case series. Settings: Department of Ophthalmology, Mayo Hospital Lahore Pakistan. Duration: Six months from January 2018 to June 2018. Methodology: The study involved 80 eyes of 40 patients; 1 affected eye planned for surgery and contralateral unaffected eye taken as control. OCT was performed before surgery and RNFL thickness was noted in each eye. Vitrectomy with peeling of ERM was performed and post-operative changes in the thickness of RNFL were reassessed by OCT at 1 and 3 months postoperatively. An informed written consent regarding participation in the study was taken from all the patients. Results: The mean age of the patients was 58.30±8.22 years. We observed a male predominance among these patients with male to female ratio of 1.9:1. Following surgery, the mean RNFL thickness at 1 and 3 months post-operatively increased significantly in superior and nasal quadrant while decreased significantly in inferior and temporal quadrant of the affected eye while it remained unchanged in the unaffected follow eye. Conclusion: In the present study, vitrectomy with ERM peeling was found to induce change in RNFL thickness which increased significantly in the superior and nasal quadrants while decreased significantly in inferior and temporal quadrant of the affected eye which warrants routine monitoring of such patients with OCT in the post-operative period.