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玻璃体切除术治疗视网膜前膜对视觉功能及视力相关生活质量的影响。

Effect of vitrectomy for epiretinal membrane on visual function and vision-related quality of life.

作者信息

Okamoto Fumiki, Okamoto Yoshifumi, Hiraoka Takahiro, Oshika Tetsuro

机构信息

Department of Ophthalmology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.

出版信息

Am J Ophthalmol. 2009 May;147(5):869-74, 874.e1. doi: 10.1016/j.ajo.2008.11.018. Epub 2009 Feb 6.

Abstract

PURPOSE

To evaluate the vision-related quality of life (VR-QOL) in patients undergoing vitrectomy for epiretinal membrane (ERM) removal and to investigate the relationship between VR-QOL and the severity of pre/postoperative metamorphopsia.

DESIGN

Prospective, interventional, consecutive, comparative case series.

METHODS

The 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was self-administered by 28 patients (age, 66.7 +/- 8.5 years, mean +/- standard deviation) with ERM before and 3 months after vitrectomy. Preoperative and postoperative clinical data were collected, including logarithm of the minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA), letter contrast sensitivity, central macular thickness, and severity of metamorphopsia. The NEI VFQ-25 was also measured in 26 age-matched normal controls.

RESULTS

The preoperative NEI VFQ-25 composite score was significantly lower in ERM patients than in normal controls (P < .0001). Vitrectomy significantly improved NEI VFQ-25 composite score as well as scores of 10 out of 12 subscales (P < .0001), except for general health and peripheral vision. The postoperative NEI VFQ-25 composite score in ERM patients, however, remained significantly lower than that in normal controls (P < .0001). The preoperative NEI VFQ-25 composite score significantly correlated with the severity of preoperative metamorphopsia (P < .05) but not with preoperative logMAR BCVA, letter contrast sensitivity, and central macular thickness. The postoperative NEI VFQ-25 composite score significantly correlated with the degree of postoperative metamorphopsia and logMAR BCVA (P < .05). The changes in NEI VFQ-25 composite score significantly correlated with changes in the severity of metamorphopsia (P < .05), but not with other parameters.

CONCLUSIONS

VR-QOL is significantly impaired in patients with ERM, which is remarkably improved by vitrectomy. The severity of metamorphopsia strongly influences VR-QOL in patients with ERM.

摘要

目的

评估接受玻璃体切除术以切除视网膜前膜(ERM)的患者的视力相关生活质量(VR-QOL),并研究VR-QOL与术前/术后视物变形严重程度之间的关系。

设计

前瞻性、干预性、连续性、比较性病例系列研究。

方法

28例ERM患者(年龄66.7±8.5岁,均值±标准差)在玻璃体切除术前及术后3个月自行填写25项美国国立眼科研究所视觉功能问卷(NEI VFQ-25)。收集术前和术后的临床数据,包括最小分辨角对数(logMAR)最佳矫正视力(BCVA)、字母对比敏感度、中心黄斑厚度和视物变形的严重程度。还对26名年龄匹配的正常对照者进行了NEI VFQ-25测量。

结果

ERM患者术前NEI VFQ-25综合评分显著低于正常对照者(P<.0001)。玻璃体切除术显著提高了NEI VFQ-25综合评分以及12个分量表中10个的评分(P<.0001),但一般健康和周边视力分量表除外。然而,ERM患者术后NEI VFQ-25综合评分仍显著低于正常对照者(P<.0001)。术前NEI VFQ-25综合评分与术前视物变形的严重程度显著相关(P<.05),但与术前logMAR BCVA、字母对比敏感度和中心黄斑厚度无关。术后NEI VFQ-25综合评分与术后视物变形程度和logMAR BCVA显著相关(P<.05)。NEI VFQ-25综合评分的变化与视物变形严重程度的变化显著相关(P<.05),但与其他参数无关。

结论

ERM患者的VR-QOL显著受损,玻璃体切除术可使其显著改善。视物变形的严重程度强烈影响ERM患者的VR-QOL。

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