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视网膜前膜和内层视网膜异常增厚患者术后黄斑中心凹内层视网膜结构的恢复

Postoperative restoration of foveal inner retinal configuration in patients with epiretinal membrane and abnormally thick inner retina.

作者信息

Yang Hyun Seung, Kim Jee Taek, Joe Soo Geun, Lee Joo Yong, Yoon Young Hee

机构信息

*Department of Ophthalmology, Ulsan University Hospital, University of Ulsan, College of Medicine, Ulsan, South Korea; †Department of Ophthalmology, Chung Ang University Hospital, University of Chung Ang, College of Medicine, Seoul, South Korea; and ‡Department of Ophthalmology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea.

出版信息

Retina. 2015 Jan;35(1):111-9. doi: 10.1097/IAE.0000000000000276.

Abstract

PURPOSE

To investigate foveal inner retinal layer (IRL) restoration and its relationship with functional visual outcomes after membrane peeling in eyes with idiopathic epiretinal membrane (ERM) with foveal central thick IRL.

METHODS

Consecutive eyes (n = 57) with a thick foveal IRL that underwent 25-gauge vitrectomy for ERM treatment were included. Complete ophthalmic and spectral domain optical coherence tomography examinations were performed before and 1 year after surgery.

RESULTS

Before surgery, mean best-corrected visual acuity (BCVA) was 20/48 (logMAR, 0.38); central foveal thickness, 515.0 ± 90.9 μm; and central IRL thickness (CIRLT) at the fovea, 167.7 ± 80.1 μm. One year after ERM peeling, mean BCVA improved to 20/30 (logMAR, 0.18), central foveal thickness to 404.1 ± 96.4 μm, and CIRLT to 76.8 ± 68.0 μm. In multivariate analysis, initial BCVA and CIRLT at baseline correlated well with final BCVA and BCVA improvement at 12 months. In comparison with Group B eyes (persistently thick foveal IRL at 12 months), Group A eyes (restored foveal IRL at 12 months) had thinner CIRLT at baseline and showed a significant post-surgical improvement in BCVA and metamorphopsia.

CONCLUSION

In eyes with idiopathic ERM and decreased vision due to abnormally thick IRL in the foveal center, postoperative visual outcomes correlated well with preoperative CIRLT and postoperative restoration of IRL configuration after ERM peeling.

摘要

目的

研究特发性黄斑前膜(ERM)伴黄斑中心凹内层视网膜(IRL)增厚的患眼在膜剥除术后黄斑中心凹IRL的恢复情况及其与功能性视力预后的关系。

方法

纳入57例因ERM接受25G玻璃体切除术治疗、黄斑中心凹IRL增厚的连续病例。术前及术后1年进行完整的眼科检查及频域光学相干断层扫描检查。

结果

术前,平均最佳矫正视力(BCVA)为20/48(logMAR,0.38);黄斑中心凹厚度为515.0±90.9μm;黄斑中心凹处的中心IRL厚度(CIRLT)为167.7±80.1μm。ERM剥除术后1年,平均BCVA提高至20/30(logMAR,0.18),黄斑中心凹厚度降至404.1±96.4μm,CIRLT降至76.8±68.0μm。多因素分析显示,基线时的初始BCVA和CIRLT与12个月时的最终BCVA及BCVA改善情况密切相关。与B组眼(12个月时黄斑中心凹IRL持续增厚)相比,A组眼(12个月时黄斑中心凹IRL恢复)基线时CIRLT更薄,术后BCVA和视物变形有显著改善。

结论

对于特发性ERM且因黄斑中心凹IRL异常增厚导致视力下降的患眼,术后视力预后与术前CIRLT以及ERM剥除术后IRL结构的恢复情况密切相关。

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