Lee Sung-Bok, Shin Yong-Il, Jo Young-Joon, Kim Jung-Yeul
Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea Research Institute for Medical Science, Chungnam National University, Daejeon, Republic of Korea.
Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
Invest Ophthalmol Vis Sci. 2014 Sep 16;55(10):6607-11. doi: 10.1167/iovs.14-14196.
We investigated longitudinal changes in retinal nerve fiber layer (RNFL) thickness following vitrectomy for epiretinal membrane (ERM).
Thirty-one patients who underwent pars plana vitrectomy with internal limiting membrane (ILM) peeling for ERM were included. Average thickness and four quadrants of RNFL thicknesses were determined before and at 1, 3, 6, and 12 months after surgery by spectral-domain optical coherence tomography (SD-OCT). As macular lesions could affect RNFL thickness, we evaluated changes in RNFL thickness by dividing the RNFL into 12 o'clock hourly positions, defining pathologic area adjacent to the lesion and nonpathologic area.
Retinal nerve fiber layer thickness of the affected eyes increased at 1 month after vitrectomy and later decreased compared to baseline values. Temporal quadrant RNFL thickness was statistically significantly thicker in affected eyes at baseline and at 1 month after surgery and thinner after 12 months than fellow eyes. Retinal nerve fiber layer thickness in pathologic area decreased after surgery, and the RNFL was statistically significantly thinner at 3, 6, and 12 months postoperatively, compared to the baseline thickness. The RNFL thickness of pathologic area of affected eyes compared to fellow eyes was thicker both at baseline and 1 month after surgery but thinner at 12 months compared to baseline values.
Postoperative RNFL thickness after vitrectomy combined with ERM removal tended to decrease postoperatively. Retinal nerve fiber layer thicknesses in temporal pathologic area were significantly reduced at 3, 6, and 12 months postoperatively compared to baseline values, whereas RNFL thicknesses in nasal nonpathologic area exhibited no significant postoperative changes. We found that ERM itself and the removal procedure resulted in decreased RNFL thickness.
我们研究了视网膜前膜（ERM）玻璃体切除术后视网膜神经纤维层（RNFL）厚度的纵向变化。
纳入31例行玻璃体切割联合内界膜（ILM）剥除术治疗ERM的患者。术前及术后1、3、6和12个月，采用频域光学相干断层扫描（SD - OCT）测定RNFL的平均厚度及四个象限的厚度。由于黄斑病变可能影响RNFL厚度，我们将RNFL分为12个钟点位置，定义病变相邻的病理区域和非病理区域，评估RNFL厚度的变化。
患眼的视网膜神经纤维层厚度在玻璃体切除术后1个月增加，随后与基线值相比下降。患眼颞侧象限RNFL厚度在基线时和术后1个月统计学上显著厚于对侧眼，12个月后变薄。手术病理区域的视网膜神经纤维层厚度术后下降，与基线厚度相比，术后3、6和12个月RNFL在统计学上显著变薄。患眼病理区域的RNFL厚度与对侧眼相比，在基线和术后1个月均较厚，但与基线值相比，12个月时变薄。
玻璃体切除联合ERM切除术后RNFL厚度术后有下降趋势。术后3、6和12个月，颞侧病理区域的视网膜神经纤维层厚度与基线值相比显著降低，而鼻侧非病理区域的RNFL厚度术后无显著变化。我们发现ERM本身及切除手术导致RNFL厚度下降。
