Fang X, Chen Z, Weng Y, Shu Z, Ni H, Jiang J, Yao K
Department of Ophthalmology, Second Affiliated Hospital, Zhejiang University, Hangzhou, China.
Eye (Lond). 2008 Nov;22(11):1430-5. doi: 10.1038/sj.eye.6702963. Epub 2007 Aug 31.
To report the clinical features of the eye of young patients with an idiopathic macular epiretinal membrane (ERM), and the visual outcomes after the surgical removal of the ERM.
A retrospective review of the medical records of eight young patients (age, 23-39 years; mean, 32.5 years) with an idiopathic macular ERM was performed. The patients underwent vitrectomy and removal of the ERM with peeling of the internal limiting membrane (ILM). The pre- and postoperative visual acuity and intra- and postoperative complications were investigated.
Ophthalmoscopically, the ERMs in seven eyes were white, opaque, and dense, while one was grayish-white and less dense. A posterior vitreous detachment was not present and the ERM adhered strongly to the underlying retina in all eight eyes. The mean best-corrected visual acuity (BCVA) preoperatively was 20/140 (Snellen; range: 20/250-20/63), and the BCVA improved significantly to 20/30 (range: 20/40-20/20) postoperatively with an average follow-up of 14.6 months (range: 6-42 months; Wilcoxon sign-rank test, P<0.001). An improvement of >7 lines was observed in seven of eight eyes. A recurrence of an ERM without involving the macula was detected in one eye (12.5%).
The clinical features of the ERMs in young patients are different from those in elderly patients, eg, thicker, more adherent to the retina, and still attached to the vitreous. Vitrectomy and removal of ERM with ILM peeling are effective and safe surgical procedures. Removal of the ILM may minimize the recurrence of an ERM.
报告特发性黄斑视网膜前膜(ERM)年轻患者眼部的临床特征,以及手术切除ERM后的视力预后。
对8例(年龄23 - 39岁,平均32.5岁)特发性黄斑ERM年轻患者的病历进行回顾性研究。患者接受了玻璃体切除术并通过剥除内界膜(ILM)来切除ERM。对术前和术后视力以及术中及术后并发症进行了调查。
眼底镜检查显示,7只眼的ERM为白色、不透明且致密,而1只眼为灰白色且较疏松。所有8只眼均无玻璃体后脱离,ERM与下方视网膜紧密粘连。术前平均最佳矫正视力(BCVA)为20/140(Snellen视力表;范围:20/250 - 20/63),术后平均随访14.6个月(范围:6 - 42个月)时,BCVA显著提高至20/30(范围:20/40 - 20/20)(Wilcoxon符号秩检验,P<0.001)。8只眼中有7只眼视力提高超过7行。1只眼(12.5%)检测到ERM复发但未累及黄斑。
年轻患者ERM的临床特征与老年患者不同,例如更厚、与视网膜粘连更紧密且仍与玻璃体相连。玻璃体切除术及剥除ILM切除ERM是有效且安全的手术方法。剥除ILM可能会减少ERM的复发。