Ferreira Saraceno Janaína Jamile, Mateus Ismênia Machado, Lopes Machado Tâmara, Gonçalves Fernando Pistarini, Negretto Alan Diego, Nakashima Yoshitaka, Gomes André Marcelo Vieira, Abujamra Suel
Instituto Suel Abujamra de Oftalmologia, São Paulo, SP, Brasil.
Arq Bras Oftalmol. 2007 Nov-Dec;70(6):935-8. doi: 10.1590/s0004-27492007000600009.
To describe the relation between visual results and macular morphology through optical coherence tomography (OCT) in patients submitted to removal of the idiopathic epiretinal membranes.
Ten eyes of ten patients with diagnosis of idiopathic epiretinal membranes underwent standard 20-G pars plana vitrectomy. Posterior hyaloid attachments were identified and dealt with. Idiopathic epiretinal membranes were removed in all cases. Corrected visual acuity, retinography, fluorescein angiography, fundus biomicroscopy and the optical coherence tomography in the pre- and postoperative periods were performed in all patients. In OCT, three characteristics were considered in each image: presence of foveal depression, presence of cystoid macular edema and mean central macular thickness.
Pre-operative visual acuity varied from 20/80 to counting fingers. The mean age was 63 years, ranging from 57 to 78 years. Five patients were male and five female. Preoperative visual acuity (VA) varied from 20/80 to CD to 1 meter. An improvement in VA of at least two lines was noted in all cases and metamorphopsia in eight eyes (80%). Four patients did not present metamorphopsia according to Amsler grid test, and the remaining presented partial improvement. On optical coherence tomography all eyes maintained increased central thickness, ranging from 232 to 605 micro (mean of 351.9 micro). Three eyes maintained cystoid macular edema. Four eyes presented final VA better or equal to 20/30. In this group the mean central thickness was of 277 micro. Foveal contour was recovered in two of these eyes. Four patients had no residual cystoid macular edema.
Optical coherence tomography is a tool that evaluates the structural changes before and after surgery to remove idiopathic epiretinal membranes. Although the foveal area architecture stays irregular six months after surgery, the visual outcomes are very promising. Other prognostics factors may be involved in the final visual results of this pathology.
通过光学相干断层扫描（OCT）描述接受特发性视网膜前膜切除手术患者的视力结果与黄斑形态之间的关系。
10例诊断为特发性视网膜前膜的患者的10只眼接受了标准的20G玻璃体切割术。识别并处理了后玻璃体附着情况。所有病例均切除特发性视网膜前膜。对所有患者在术前和术后进行了矫正视力、视网膜照相、荧光素血管造影、眼底生物显微镜检查以及光学相干断层扫描。在OCT检查中，每张图像考虑三个特征：黄斑中心凹凹陷情况、黄斑囊样水肿情况以及黄斑中心平均厚度。
术前视力从20/80到数指。平均年龄为63岁，范围在57至78岁之间。5例为男性，5例为女性。术前视力（VA）从20/80到1米数指不等。所有病例均观察到视力至少提高两行，8只眼（80%）有视物变形。根据阿姆斯勒方格表检查，4例患者没有视物变形，其余患者有部分改善。在光学相干断层扫描中，所有眼的中心厚度均增加，范围从232至605微米（平均351.9微米）。3只眼存在黄斑囊样水肿。4只眼最终视力达到或优于20/30。在这组眼中，黄斑中心平均厚度为277微米。其中2只眼的黄斑轮廓恢复。4例患者没有残留的黄斑囊样水肿。
光学相干断层扫描是一种评估特发性视网膜前膜切除手术前后结构变化的工具。尽管术后6个月黄斑区结构仍不规则，但视力结果很有前景。其他预后因素可能与该疾病的最终视力结果有关。
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