Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Japan.
Am J Ophthalmol. 2012 Apr;153(4):698-704, 704.e1. doi: 10.1016/j.ajo.2011.09.011. Epub 2012 Jan 14.
To evaluate the prognostic value of the cone outer segment tips (COST) and other features using spectral-domain optical coherence tomography (SD-OCT) in patients undergoing epiretinal membrane (ERM) surgery.
Retrospective observational case series.
Fifty eyes of 49 patients that underwent vitrectomy for idiopathic ERM were studied. Best-corrected visual acuity (BCVA) and SD-OCT images were examined preoperatively and at 1 and 6 months postoperatively. The SD-OCT features evaluated included central foveal thickness (CFT) and the status and defect diameter of the external limiting membrane (ELM), the photoreceptor inner/outer segment (IS/OS) junction, and the COST line. The associations between SD-OCT parameters and BCVA were analyzed.
There was no ELM disruption found, and thus the eyes were categorized into 3 groups: Group A, with a continuous IS/OS and COST line; Group B, with a continuous IS/OS but disrupted COST line; and Group C, with a disrupted IS/OS and COST line. At 6 months, Group A showed a significantly better BCVA than Group B (P<.005), and poorer BCVA was noted in Group C (P=.034). Defect diameters of IS/OS and COST line were also significantly correlated with BCVA postoperatively. The BCVA at 6 months was better in order of Group A, B, and C as assigned at baseline (P<.05) or 1 month (P<.001). There was no significant correlation between CFT and BCVA.
The status of the COST line, in conjunction with the IS/OS junction, is a useful prognostic factor after ERM surgery.
评估在接受视网膜前膜（ERM）手术的患者中，使用频域光相干断层扫描（SD-OCT）的圆锥外节尖端（COST）和其他特征的预后价值。
回顾性观察性病例系列。
对 49 例 50 只眼进行了玻璃体切除术治疗特发性 ERM。在术前和术后 1 个月和 6 个月检查最佳矫正视力（BCVA）和 SD-OCT 图像。评估的 SD-OCT 特征包括中央黄斑厚度（CFT）和外节限膜（ELM）的状态和缺损直径、光感受器内/外节（IS/OS）交界处和 COST 线。分析 SD-OCT 参数与 BCVA 之间的关系。
未发现 ELM 中断，因此将眼分为 3 组：A 组，IS/OS 和 COST 线连续；B 组，IS/OS 连续但 COST 线中断；C 组，IS/OS 和 COST 线中断。6 个月时，A 组的 BCVA 明显优于 B 组（P<.005），C 组的 BCVA 较差（P=.034）。IS/OS 和 COST 线的缺损直径与术后 BCVA 也呈显著相关。根据基线（P<.05）或 1 个月（P<.001）时的分组，6 个月时的 BCVA 按 A、B 和 C 组的顺序更好。CFT 与 BCVA 无显著相关性。
COST 线的状态与 IS/OS 交界处结合在一起，是 ERM 手术后有用的预后因素。
