Inoue Maiko
Department of Ophthalmology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan.
Nippon Ganka Gakkai Zasshi. 2012 Nov;116(11):1029-36.
Microincision vitrectomy surgery of an idiopathic epiretinal membrane (ERM) is useful for improving vision. However, some cases show poor visual recovery even after complete removal of the ERM. Although several prognostic factors are suggested influencing the postoperative visual acuity, we report that the presence of an intact inner segment/outer segment junction (IS/OS junction) on the preoperative spectral-domain OCT (SD-OCT) images is an important predictor of better visual recovery and better postoperative best-corrected visual acuity after ERM surgery. We also evaluated the anatomic features of the IS/OS junction both before and after surgery by SD-OCT. The postoperative disruption of the IS/OS junction observed in eyes with preoperative intact IS/OS junction was reversible at 12 months after surgery. On the other hand, none of the eyes with preoperative disrupted IS/OS junction showed any structural recovery of the IS/OS junction over a 1-year follow-up period. Furthermore, visual acuity and visual recovery in eyes with an intact IS/OS junction, as assessed before surgery, were better than in the eyes with a disrupted or irregular IS/OS junction. By evaluating the macular microstructure, SD-OCT enabled the prediction of visual acuity outcome after ERM surgery.
特发性视网膜前膜（ERM）的微创玻璃体切除术对改善视力很有用。然而，一些病例即使在完全切除ERM后视力恢复仍较差。尽管有几种预后因素被认为会影响术后视力，但我们报告术前光谱域光学相干断层扫描（SD-OCT）图像上完整的内节/外节连接（IS/OS连接）的存在是ERM手术后视力更好恢复和术后最佳矫正视力更好的重要预测指标。我们还通过SD-OCT评估了手术前后IS/OS连接的解剖特征。术前IS/OS连接完整的眼睛术后观察到的IS/OS连接中断在术后12个月是可逆的。另一方面，术前IS/OS连接中断的眼睛在1年的随访期内均未显示出IS/OS连接的任何结构恢复。此外，术前评估时IS/OS连接完整的眼睛的视力和视力恢复情况优于IS/OS连接中断或不规则的眼睛。通过评估黄斑微结构，SD-OCT能够预测ERM手术后的视力结果。
