Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
Ophthalmology. 2014 Oct;121(10):1976-82. doi: 10.1016/j.ophtha.2014.04.011. Epub 2014 May 29.
To investigate the prevalence of vitreopapillary traction (VPT) and its effect on peripapillary structure and visual function in eyes with idiopathic epiretinal membrane (ERM).
Observational, comparative study.
Patients with idiopathic ERM (n = 116 eyes) and controls with similar age (n = 62 eyes).
Spectral domain optical coherence tomography (SD-OCT) axial optic disc scans were evaluated to identify VPT in eyes with idiopathic ERM. Based on VPT presence/absence, eyes were categorized as ERM with VPT (ERM+VPT, n = 52 eyes) or ERM without VPT (ERM-VPT, n = 64 eyes). Optic nerve head (ONH) parameters, average and sectoral retinal nerve fiber layer (RNFL) thickness, and central macular thickness (CMT) were compared between groups. Best-corrected visual acuity (BCVA) and visual field (VF) (automated Humphrey central 30-2 perimetry) mean deviation (MD) and pattern standard deviation (PSD) were compared between groups.
The ONH parameters, peripapillary RNFL thickness, BCVA, VF MD, and PSD.
Fifty-two of 116 eyes (44.8%) with idiopathic ERM had VPT. The ERM+VPT group had larger rim area, smaller average and vertical cup-to-disc ratios, and smaller cup volume than ERM-VPT and normal groups (all P < 0.001). Eyes with VPT had greater CMT than eyes without VPT (421.87±97.31 μm vs. 377.08±75.1 μm; P = 0.006). Average and temporal RNFL thickness was higher in ERM+VPT (98.64±9.33 μm and 93.90±23.42 μm) than in normal eyes (94.02±8.45 μm and 66.42±12.71 μm). No significant difference in BCVA was found between ERM-VPT and ERM+VPT eyes, but MD was lower in ERM+VPT than in ERM-VPT (-3.91±3.68 dB vs. -2.18±2.42 dB; P = 0.005). Additionally, PSD was greater in ERM+VPT. Multivariate logistic regression analysis revealed that age (odds ratio [OR], 1.190; P = 0.014) and increased CMT (OR, 1.013; P = 0.005) were associated with vision loss, whereas VPT presence was associated with VF defects (OR, 6.290; P = 0.024).
Vitreopapillary traction was observed in >40% of eyes with idiopathic ERM, as confirmed by SD-OCT imaging. Vitreopapillary traction with idiopathic ERM was associated with altered optic disc architecture, increased average and temporal RNFL thickness, and VF defects.
研究特发性视网膜内界膜（ERM）患者中玻璃体细胞-视盘牵引（VPT）的发生率及其对视神经结构和视功能的影响。
观察性、对比性研究。
特发性 ERM 患者（n = 116 只眼）和年龄匹配的对照组（n = 62 只眼）。
通过频域光学相干断层扫描（SD-OCT）轴向视神经盘扫描，识别特发性 ERM 患者的 VPT。根据 VPT 的存在/缺失，将眼分为特发性 ERM 伴 VPT（ERM+VPT，n = 52 只眼）或特发性 ERM 无 VPT（ERM-VPT，n = 64 只眼）。比较两组视神经头（ONH）参数、平均和节段视网膜神经纤维层（RNFL）厚度以及中央黄斑厚度（CMT）。比较两组最佳矫正视力（BCVA）和视野（VF）（自动 Humphrey 中央 30-2 视野计）平均偏差（MD）和模式标准差（PSD）。
ONH 参数、视盘周围 RNFL 厚度、BCVA、VF MD 和 PSD。
116 只特发性 ERM 眼中，52 只（44.8%）存在 VPT。与 ERM-VPT 组和正常组相比，ERM+VPT 组的边缘面积更大，平均和垂直杯盘比更小，杯容积更小（均 P < 0.001）。存在 VPT 的眼比不存在 VPT 的眼 CMT 更大（421.87±97.31 μm vs. 377.08±75.1 μm；P = 0.006）。与正常眼相比，ERM+VPT 眼的平均和颞侧 RNFL 厚度更高（98.64±9.33 μm 和 93.90±23.42 μm）。ERM-VPT 眼和 ERM+VPT 眼的 BCVA 无显著差异，但 ERM+VPT 眼的 MD 更低（-3.91±3.68 dB vs. -2.18±2.42 dB；P = 0.005）。此外，ERM+VPT 眼的 PSD 更大。多变量逻辑回归分析显示，年龄（比值比 [OR]，1.190；P = 0.014）和 CMT 增加（OR，1.013；P = 0.005）与视力下降相关，而 VPT 存在与 VF 缺陷相关（OR，6.290；P = 0.024）。
通过 SD-OCT 成像证实，特发性 ERM 患者中 >40%存在玻璃体细胞-视盘牵引。特发性 ERM 合并 VPT 与视神经盘结构改变、平均和颞侧 RNFL 厚度增加以及 VF 缺陷有关。
