Michalewska Zofia, Michalewski Janusz, Adelman Ron A, Zawiślak Ewa, Nawrocki Jerzy
*Ophthalmic Clinic "Jasne Blonia," Lodz, Poland; †Third Municipal Hospital K. Jonscher, Lodz, Poland; and ‡Yale University School of Medicine, New Haven, Connecticut.
Retina. 2015 Mar;35(3):487-91. doi: 10.1097/IAE.0000000000000350.
In eyes with epiretinal membranes (ERMs), retinal arteries become dilated and tortuous. This may correlate with the hemodynamics of the affected areas and possibly with choroidal thickness. The aim of this study was to estimate choroidal thickness before and after vitrectomy for idiopathic ERM in the operated eye and in the unaffected fellow eye.
A prospective study of 21 patients with idiopathic ERMs. We obtained swept source optical coherence tomography images that simultaneously evaluated the vitreous, retina, and choroid. We performed choroidal thickness measurements before pars plana vitrectomy with ERM removal and internal limiting membrane peeling. We took subsequent images 10 days and then 3 months after surgery. We compared the images with patients' fellow eyes. In each eye, we performed 256 horizontal scans, 12 mm in length and centered on the fovea. We manually calculated choroidal thickness from the posterior edge of the retinal pigment epithelium to the choroidoscleral boundary with the built-in caliper and additionally measured it automatically using DRI-OCT mapping software. We evaluated the outer choroidoscleral boundary and performed statistical analysis.
We observed an ERM in 50% of fellow eyes. Mean choroidal thickness did not differ between study and fellow eyes (P = 0.67). Choroidal thickness decreased from 200 μm to 173 μm (P = 0.034) 3 months after vitrectomy and internal limiting membrane peeling. In all but two cases, the outer choroidoscleral boundary was irregular. Additionally, we observed that the suprachoroidal layer consists of two bands in four cases, an inner hyperreflective band and an outer hyporeflective one. We speculate the latter correlates with the suprachoroidal space.
Normalization of choroidal thickness after surgery suggests that there is some relationship between choroidal thickness and structure and the presence of idiopathic ERMs.
在患有视网膜前膜（ERM）的眼中，视网膜动脉会变得扩张和迂曲。这可能与受累区域的血流动力学相关，也可能与脉络膜厚度有关。本研究的目的是评估特发性ERM患者手术眼和未受影响的对侧眼在玻璃体切除术前和术后的脉络膜厚度。
对21例特发性ERM患者进行前瞻性研究。我们获取了扫频源光学相干断层扫描图像，该图像可同时评估玻璃体、视网膜和脉络膜。我们在进行切除ERM和内界膜剥除的经睫状体平坦部玻璃体切除术之前测量脉络膜厚度。术后10天及3个月拍摄后续图像。我们将这些图像与患者的对侧眼进行比较。在每只眼中，我们进行了256次水平扫描，扫描长度为12毫米，以黄斑中心凹为中心。我们使用内置卡尺从视网膜色素上皮的后缘到脉络膜巩膜边界手动计算脉络膜厚度，并另外使用DRI-OCT测绘软件自动测量。我们评估了脉络膜巩膜外边界并进行了统计分析。
我们在50%的对侧眼中观察到ERM。研究眼和对侧眼的平均脉络膜厚度无差异（P = 0.67）。玻璃体切除和内界膜剥除术后3个月，脉络膜厚度从200μm降至173μm（P = 0.034）。除两例外，所有病例的脉络膜巩膜外边界均不规则。此外，我们在4例病例中观察到脉络膜上层由两条带组成，一条内侧高反射带和一条外侧低反射带。我们推测后者与脉络膜上腔相关。
手术后脉络膜厚度恢复正常表明脉络膜厚度和结构与特发性ERM的存在之间存在某种关系。
