Pierro Luisa, Iuliano Lorenzo, Gagliardi Marco, Codenotti Marco, Ambrosi Alessandro, Bandello Francesco
Department of Ophthalmology, Vita-Salute University, San Raffaele ScientificInstitute, Via Olgettina 60, 20132, Milan, Italy,
Graefes Arch Clin Exp Ophthalmol. 2015 Jan;253(1):37-45. doi: 10.1007/s00417-014-2665-8. Epub 2014 May 23.
To investigate the Ganglion Cell Complex (GCC) thickness change and visual recovery correlation after surgery for an idiopathic epiretinal membrane (ERM).
In this prospective, observational, case control study 30 eyes underwent vitrectomy for idiopathic ERM. We analysed best-corrected visual acuity (BCVA), mean macular thickness and mean GCC thickness one day before surgery, seven days and six months after surgery. Internal segment/outer segment junction, external limiting membrane, cone outer segment tips defects and intraretinalfluid were also investigated throughout the follow-up.
Baseline GCC thickness was higher in patients with ERM (130 ± 13 μm) compared with healthy eyes (94 ± 5 μm; p < 0.0001). GCC thickness decreased after surgery to 89 ± 11 μm (p < 0.0001), reaching a value similar to controls (p = 0.12). Preoperative macular thickness was 318 ± 32 μm and decreased to 281 ± 18 μm (p < 0.0001), remaining significantly higher than controls (260 ± 8 μm; p < 0.0001). The GCC proportion of the whole macular thickness was also reduced six months after surgery (p < 0.0001). Post-operative BCVA gain showed direct correlation with GCC reduction (R = 0.67, p < 0.0001), but did not correlate with the mean macular thickness reduction (R < 0.01, p = 0.97).
Ganglion cell complex thickness is higher in eyes with idiopathic ERM, and after surgery turns back to similar values of healthy eyes. Post-operative GCC reduction is proportionally higher than thinning of the whole retina, and this reduction is correlated with visual restoration.
研究特发性视网膜前膜(ERM)手术后神经节细胞复合体(GCC)厚度变化与视力恢复的相关性。
在这项前瞻性、观察性病例对照研究中,30只眼睛接受了特发性ERM玻璃体切除术。我们分析了手术前一天、手术后七天和六个月的最佳矫正视力(BCVA)、平均黄斑厚度和平均GCC厚度。在整个随访过程中,还对视网膜内节/外节交界处、外界膜、视锥细胞外节尖端缺陷和视网膜内液进行了研究。
与健康眼睛(94±5μm;p<0.0001)相比,ERM患者的基线GCC厚度更高(130±13μm)。手术后GCC厚度降至89±11μm(p<0.0001),达到与对照组相似的值(p=0.12)。术前黄斑厚度为318±32μm,降至281±18μm(p<0.0001),仍显著高于对照组(260±8μm;p<0.0001)。手术后六个月,GCC在整个黄斑厚度中的比例也降低了(p<0.0001)。术后BCVA的提高与GCC的减少呈直接相关(R=0.67,p<0.0001),但与平均黄斑厚度的减少无关(R<0.01,p=0.97)。
特发性ERM患者的神经节细胞复合体厚度更高,手术后恢复至与健康眼睛相似的值。术后GCC的减少比例高于整个视网膜的变薄,且这种减少与视力恢复相关。