Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan.
Retina. 2011 Jul-Aug;31(7):1366-72. doi: 10.1097/IAE.0b013e318203c156.
To evaluate the macular structure on spectral-domain optical coherence tomographic (SD-OCT) images to predict the outcome of surgery for idiopathic epiretinal membrane.
Forty-five eyes of 45 consecutive patients with idiopathic epiretinal membrane who had a preoperative visual acuity of ≤ 20/32 and were scheduled to undergo a transconjunctival 25-gauge vitrectomy were involved in this prospective cohort study. The best-corrected visual acuity (BCVA) and SD-OCT images of the fovea were examined before the surgery and at 3, 6, and 12 months after the surgery. Associations between the visual acuity parameters and the preoperative SD-OCT features, including the morphology of the photoreceptor inner segment/outer segment junction, macular thickness, presence/absence of retinal cysts, and presence/absence of a macular pseudohole, were investigated as predictors of the outcome of the surgery. The main outcome measures were the association between the macular microstructure on preoperative SD-OCT images and the visual acuity parameters, such as the BCVA, at 12 months after the surgery (postoperative BCVA) and the difference between the preoperative visual acuity and the postoperative BCVA.
A total of 45 patients were enrolled in this study. The postoperative visual acuity was significantly better for the eyes with an intact inner segment/outer segment junction on the preoperative SD-OCT images than for those with an irregular or a disrupted inner segment/outer segment junction on the images (P < 0.001). Better preoperative visual acuity was associated with better visual acuity at 12 months and a lesser degree of improvement in the visual acuity (P < 0.001, respectively).
The presence of an intact inner segment/outer segment junction on the preoperative SD-OCT images was found to be an important predictor of better visual recovery and better postoperative BCVA after epiretinal membrane surgery.
评估频域光相干断层扫描（SD-OCT）图像的黄斑结构，以预测特发性视网膜内界膜剥离手术的结果。
本前瞻性队列研究纳入了 45 例特发性视网膜内界膜剥离患者（45 只眼），这些患者术前视力均≤20/32，并计划接受经结膜 25G 玻璃体切除术。在术前以及术后 3、6 和 12 个月时，对最佳矫正视力（BCVA）和黄斑区的 SD-OCT 图像进行了检查。研究了视力参数与术前 SD-OCT 特征（包括光感受器内外节连接形态、黄斑厚度、是否存在视网膜裂孔以及是否存在黄斑假孔）之间的相关性，以确定这些特征是否可预测手术结果。主要观察指标为术前 SD-OCT 图像上的黄斑微观结构与术后 12 个月时的视力参数（术后 BCVA）以及术前视力与术后 BCVA 之间的差异之间的相关性。
本研究共纳入 45 例患者。与术前 SD-OCT 图像上的光感受器内外节连接形态不规则或中断的眼相比，图像上的光感受器内外节连接形态完整的眼术后视力明显更好（P<0.001）。术前视力较好与术后 12 个月时视力较好以及视力改善程度较小相关（P<0.001）。
术前 SD-OCT 图像上存在完整的光感受器内外节连接被发现是特发性视网膜内界膜剥离手术后视力恢复更好和术后 BCVA 更好的重要预测指标。
