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外膜剥除术后板层黄斑裂孔的手术治疗。

Surgical treatment of lamellar macular hole secondary to epiretinal membrane.

机构信息

Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2013 Dec;251(12):2681-8. doi: 10.1007/s00417-013-2364-x. Epub 2013 May 17.

Abstract

BACKGROUND

To examine the surgical results of lamellar macular hole (LMH) secondary to epiretinal membrane (ERM).

METHODS

A 3-year retrospective review was performed of patients with LMH secondary to ERM that underwent ERM and internal limiting membrane (ILM) peeling. The main outcome measures included best-corrected visual acuity (BCVA) and postoperative macular structure. The results were compared with cases of idiopathic ERM with similar baseline demographic characteristics.

RESULTS

Thirty eyes in 30 patients were collected. The mean BCVA improvement was 3.4 Snellen lines after a mean follow-up period of 16.9 months. Optical coherence tomography (OCT) showed improved macular contour in 27 cases. Patients with intravitreal gas tamponade exhibited a higher percentage of restoration of macular contour than those without (P = 0.016). Final BCVA was correlated with an intact photoreceptor inner segment-outer segment (IS-OS) junction (P = 0.03). The degree of visual improvement is less than that observed in idiopathic ERM patients.

CONCLUSION

In LMH secondary to ERM with significant visual decrease, ERM and ILM peeling may improve BCVA. Postoperative gas tamponade is associated with better restoration of macular configuration. Final BCVA is related to an intact photoreceptor IS-OS junction rather than to the normalization of the macular contour.

摘要

背景

探讨因视网膜内表面膜(ERM)引起的板层黄斑裂孔(LMH)的手术结果。

方法

对因 ERM 而行 ERM 和内界膜(ILM)剥除术的 LMH 患者进行了为期 3 年的回顾性研究。主要观察指标包括最佳矫正视力(BCVA)和术后黄斑结构。并将结果与具有相似基线人口统计学特征的特发性 ERM 病例进行了比较。

结果

共收集了 30 例 30 只眼。平均随访 16.9 个月后,平均 BCVA 提高了 3.4 行 Snellen 视力表。27 例 OCT 显示黄斑轮廓改善。与未行眼内气体填充的患者相比,行眼内气体填充的患者黄斑轮廓恢复的比例更高(P = 0.016)。最终 BCVA 与完整的光感受器内节-外节(IS-OS)连接相关(P = 0.03)。视力改善程度低于特发性 ERM 患者。

结论

在因 ERM 导致明显视力下降的 LMH 中,行 ERM 和 ILM 剥除术可能会提高 BCVA。术后气体填充与更好地恢复黄斑形态有关。最终的 BCVA 与完整的光感受器 IS-OS 连接有关,而与黄斑轮廓的正常化无关。

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