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To investigate whether the parafoveal capillary architecture predicts clinical course and visual outcomes after ERM surgery. A total of 71 eyes of 71 patients treated with vitrectomy for idiopathic ERM were enrolled. The parafoveal capillary displacement and fractal geometries were compared according to the stage of ERM. Correlations between the parafoveal capillary displacement in the superficial capillary plexus (SCP), the fractal dimension and lacunarity in the deep capillary plexus (DCP), foveal thickness, and visual outcomes were e