Okamoto Fumiki, Okamoto Yoshifumi, Hiraoka Takahiro, Oshika Tetsuro
Department of Ophthalmology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
Am J Ophthalmol. 2009 May;147(5):869-74, 874.e1. doi: 10.1016/j.ajo.2008.11.018. Epub 2009 Feb 6.
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.
Prospective, interventional, consecutive, comparative case series.
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.
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.
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.
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。
前瞻性、干预性、连续性、比较性病例系列研究。
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。
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。
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。