Park Sun Ho, Kim Yong Joon, Lee Sung Jin
Department of Ophthalmology, Soonchunhyang University College of Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
Retina. 2016 Aug;36(8):1469-73. doi: 10.1097/IAE.0000000000000949.
To investigate the incidence of and risk factors for a dissociated optic nerve fiber layer (DONFL) after epiretinal membrane surgery.
Two hundred and ninety-six primary pars plana vitrectomy operations for epiretinal membrane that were eligible for inclusion in the study. All patients received a complete ophthalmologic examination and color fundus photography, optical coherence tomography preoperatively and postoperatively. DONFL group and non-DONFL group was compared. Univariate and multivariate analyses were performed to establish the risk factors for DONFL.
A DONFL developed in 30 of the 296 eyes (incidence, 10.1%). Internal limiting membrane (ILM) peeling was performed in 29 of 30 eyes (96.7%) in the DONFL group and 126 of 266 eyes (47.4%) in the control group (P < 0.001). Intravitreal gas tamponade was performed in 21 eyes (70.0%) in the DONFL group and 133 eyes (50.0%) in the control group (P = 0.038). The ILM peeling (odds ratio, 32.22 [4.33-240.0]; P = 0.001) and intravitreal gas tamponade (odds ratio, 2.33 [1.03-5.28]; P = 0.042) were significantly associated with DONFL.
It was found that ILM peeling and intravitreal gas tamponade were correlated with postoperative DONFL. The ILM peeling with intravitreal gas tamponade was more strongly correlated with postoperative DONFL formation than was ILM peeling alone.
研究视网膜前膜手术后视神经纤维层分离(DONFL)的发生率及危险因素。
对296例符合纳入标准的原发性视网膜前膜行玻璃体切除术的患者进行研究。所有患者术前及术后均接受全面的眼科检查、彩色眼底照相及光学相干断层扫描。比较DONFL组和非DONFL组。进行单因素和多因素分析以确定DONFL的危险因素。
296只眼中有30只发生DONFL(发生率为10.1%)。DONFL组30只眼中29只(96.7%)进行了内界膜(ILM)剥除,对照组266只眼中126只(47.4%)进行了ILM剥除(P<0.001)。DONFL组21只眼(70.0%)进行了玻璃体腔内气体填塞,对照组133只眼(50.0%)进行了玻璃体腔内气体填塞(P = 0.038)。ILM剥除(比值比,32.22[4.33 - 240.0];P = 0.001)和玻璃体腔内气体填塞(比值比,2.33[1.03 - 5.28];P = 0.042)与DONFL显著相关。
发现ILM剥除和玻璃体腔内气体填塞与术后DONFL相关。与单独的ILM剥除相比,ILM剥除联合玻璃体腔内气体填塞与术后DONFL形成的相关性更强。