Nam Dong Heun, Desouza Philip J, Hahn Paul, Tai Vincent, Sevilla Monica B, Tran-Viet Du, Cunefare David, Farsiu Sina, Izatt Joseph A, Toth Cynthia A
*Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina; †Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea; ‡Duke University School of Medicine, Durham, North Carolina; and §Department of Biomedical Engineering, Pratt School of Engineering, Durham, North Carolina.
Retina. 2015 Aug;35(8):1622-30. doi: 10.1097/IAE.0000000000000534.
To report the intraoperative optical coherence tomography findings in idiopathic epiretinal membrane (ERM) with connecting strands and to describe the postoperative outcomes.
A retrospective, case series study within a prospective observational intraoperative optical coherence tomography imaging study was performed. Epiretinal membranes with connecting strands were characterized on preoperative spectral domain optical coherence tomography images and assessed against corresponding intraoperative (after internal limiting membrane [ILM] peeling) and postoperative spectral domain optical coherence tomography images.
Eleven locations of the connecting strands in 7 eyes were studied. The connecting strands had visible connections from the inner retinal surface to the ERM in all locations, and the reflectivity was moderate in 8 locations and high in 3 locations. After ERM and ILM peeling, disconnected strands were identified in all of the intraoperative optical coherence tomography images. The reflectivity of the remaining intraoperative strands was higher than that of the preoperative lesions and appeared as "finger-like" and branching projections. The remaining disconnected lesions were contiguous with the inner retinal layers. Postoperatively, the intraoperative lesions disappeared completely in all locations, and recurrent formation of ERM was not identified in any eyes.
In ERM eyes with connecting strands, intraoperative spectral domain optical coherence tomography imaging showed moderately to highly reflective sub-ILM finger-like lesions that persist immediately after membrane and ILM peeling. Postoperatively, the hyperreflective lesions disappeared spontaneously without localized nerve fiber layer loss. The sub-ILM connecting strands may represent glial retinal attachments.
报告伴有连接条索的特发性视网膜前膜（ERM）的术中光学相干断层扫描结果，并描述术后结局。
在一项前瞻性观察性术中光学相干断层扫描成像研究中进行了一项回顾性病例系列研究。对术前光谱域光学相干断层扫描图像上伴有连接条索的视网膜前膜进行特征描述，并与相应的术中（内界膜[ILM]剥除后）及术后光谱域光学相干断层扫描图像进行对比评估。
对7只眼中连接条索的11个部位进行了研究。在所有部位，连接条索均可见从视网膜内表面至ERM的连接，其中8个部位的反射率为中等，3个部位为高反射率。在ERM和ILM剥除后，所有术中光学相干断层扫描图像中均发现条索断开。术中剩余条索的反射率高于术前病变，表现为“手指样”和分支状突起。剩余的断开病变与视网膜内层相邻。术后，所有部位的术中病变均完全消失，且未在任何眼中发现ERM复发形成。
在伴有连接条索的ERM眼中，术中光谱域光学相干断层扫描成像显示，在膜和ILM剥除后立即存在中等至高度反射性的ILM下手指样病变。术后，高反射性病变自发消失，未出现局部神经纤维层缺失。ILM下连接条索可能代表视网膜胶质附着。
