Sugiura Yoshimi, Okamoto Fumiki, Okamoto Yoshifumi, Hiraoka Takahiro, Oshika Tetsuro
Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
Invest Ophthalmol Vis Sci. 2014 Nov 4;55(11):7594-600. doi: 10.1167/iovs.14-14035.
To evaluate contrast sensitivity (CS) in patients with epiretinal membrane (ERM) following vitrectomy and to investigate the relationship between CS and foveal microstructures with spectral-domain optical coherence tomography (SD-OCT).
Thirty-one eyes of 31 patients with ERM were included. We examined CS with a CSV-1000E chart, a logMAR best-corrected visual acuity (BCVA), and foveal microstructure by using SD-OCT before and at 6 months after surgery. From the CS data, the area under the log contrast sensitivity function (AULCSF) was calculated. Based on the OCT images, we quantified the mean thickness of the ganglion cell layer (GCL), the inner nuclear layer (INL), and the outer retinal layer (outer nuclear layer and outer plexiform layer [ONL+OPL]). The status of the photoreceptor inner and outer segment junction (IS/OS) and external limiting membrane (ELM) was also evaluated.
Vitrectomy significantly improved logMAR BCVA and AULCSF. Even in patients with poor improvement of visual acuity (changes in logMAR BCVA by surgery was ≤0.2), postoperative AULCSF significantly increased by treatment (P < 0.05). Postoperative AULCSF showed a significant correlation with preoperative (P < 0.05) and postoperative (P < 0.05) ONL+OPL thickness, whereas other parameters were not relevant. Postoperative logMAR BCVA significantly correlated with postoperative status of IS/OS (P < 0.05) and preoperative ONL+OPL thickness (P < 0.05).
In patients with ERM, CS improved even though their visual acuity did not recover significantly by vitrectomy. CS was associated with the thickness of outer retinal layer.
评估玻璃体切除术后视网膜前膜(ERM)患者的对比敏感度(CS),并利用光谱域光学相干断层扫描(SD - OCT)研究CS与黄斑区微观结构之间的关系。
纳入31例ERM患者的31只眼。我们在手术前及术后6个月使用CSV - 1000E图表检查CS、测量logMAR最佳矫正视力(BCVA),并通过SD - OCT观察黄斑区微观结构。根据CS数据计算对数对比敏感度函数下的面积(AULCSF)。基于OCT图像,我们量化了神经节细胞层(GCL)、内核层(INL)和视网膜外层(外核层和外丛状层[ONL + OPL])的平均厚度。还评估了光感受器内外节连接(IS/OS)和外界膜(ELM)的状态。
玻璃体切除术显著改善了logMAR BCVA和AULCSF。即使在视力改善不佳的患者中(手术导致logMAR BCVA变化≤0.2),术后AULCSF也因治疗而显著增加(P < 0.05)。术后AULCSF与术前(P < 0.05)和术后(P < 0.05)的ONL + OPL厚度显著相关,而其他参数无关。术后logMAR BCVA与术后IS/OS状态(P < 0.05)和术前ONL + OPL厚度(P < 0.05)显著相关。
在ERM患者中,尽管玻璃体切除术未能使视力显著恢复,但CS仍有所改善。CS与视网膜外层厚度相关。