Tari Samir R, Vidne-Hay Orit, Greenstein Vivienne C, Barile Gaetano R, Hood Donald C, Chang Stanley
Department of Ophthalmology, Columbia University, 635 West 165th Street, New York, NY 10032, USA.
Retina. 2007 Jun;27(5):567-72. doi: 10.1097/IAE.0b013e31802ea53d.
To investigate the role of structural and functional measurements in the assessment of internal limiting membrane (ILM) peeling for the treatment of eyes with macular pucker.
Ten patients with macular pucker who underwent pars plana vitrectomy with ILM peeling were studied prospectively. Visual acuity measurement, standard automated achromatic perimetry, multifocal electroretinography (mfERG), and optical coherence tomography (OCT) were performed before and 3 months after surgery. Four surgical samples obtained from similar patients were analyzed with electron microscopy.
Three months after surgery, mean visual acuity +/- SD was significantly improved from 0.4 +/- 0.11 logMAR to 0.19 +/- 0.13 logMAR (P < or = 0.002), and mean central retinal thickness +/- SD was significantly decreased 428 +/- 73 microm to 326 +/- 34 microm (P < or = 0.002). The mfERG response amplitudes were slightly decreased in eight patients, and five of these patients also had asymptomatic decreases in visual field sensitivity. The electron micrographs revealed segments of Müller cell footplates on the retinal side of the ILM in all four specimens.
In this study, the use of mfERG, OCT, and standard automated achromatic perimetry showed changes in macular function and structure postoperatively. These measures of visual function and structure allow for better evaluation of the surgical outcome and understanding of the changes that may occur after ILM peeling.
探讨结构和功能测量在评估用于治疗黄斑皱襞的内界膜（ILM）剥除术中的作用。
对10例行玻璃体视网膜手术联合ILM剥除术治疗黄斑皱襞的患者进行前瞻性研究。在手术前及术后3个月进行视力测量、标准自动色觉视野检查、多焦视网膜电图（mfERG）及光学相干断层扫描（OCT）检查。对4例来自相似患者的手术标本进行电子显微镜分析。
术后3个月，平均视力±标准差从0.4±0.11 logMAR显著提高至0.19±0.13 logMAR（P≤0.002），平均视网膜中央厚度±标准差从428±73微米显著降至326±34微米（P≤0.002）。8例患者的mfERG反应振幅略有下降，其中5例患者的视野敏感度也出现无症状下降。电子显微镜照片显示，在所有4个标本的ILM视网膜侧均有米勒细胞脚板节段。
在本研究中，使用mfERG、OCT和标准自动色觉视野检查显示了术后黄斑功能和结构的变化。这些视觉功能和结构测量方法有助于更好地评估手术效果，并了解ILM剥除术后可能发生的变化。
