Liu Hsin-Yu, Hsieh Yi-Ting, Yang Chung-May
Department of Ophthalmology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan.
College of Medicine, National Taiwan University, Taipei, Taiwan.
Graefes Arch Clin Exp Ophthalmol. 2016 Sep;254(9):1723-9. doi: 10.1007/s00417-016-3276-3. Epub 2016 Jan 23.
The purpose was to investigate the paravascular abnormalities (PVA) around the retinal vascular arcades and their post-operative evolution in eyes with epiretinal membranes (ERM).
This is an observational case series. Fifty-seven eyes of 55 patients with concurrent PVA and ERM were studied (study group). Forty-one eyes in 41 patients with ERM but no PVA served as controls. Multiple optical coherence tomography (OCT) scans were made along the upper and lower arcades and across the fovea in each patient. Serial fundus photography and OCT scans were performed in eyes receiving an operation. All surgeries were performed by one surgeon. The incidence and location of paravascular retinal cysts, deep cystic spaces underneath the vessels, and paravascular retinal defects, as well as vitreoretinal interface changes, were determined and correlated with macular thickness.
In the study group, paravascular retinal cysts were detected in 57 eyes (100 %), deep cystic spaces in nine eyes (15.8 %), and paravascular lamellar holes in 31 eyes (54.4 %). No case had a full-thickness hole. ERM adhesion to the PVA was noted in 16 eyes (28.1 %) and internal limiting membrane (ILM) changes over the PVA in 22 eyes (38.6 %). Compared with the control, the study group had significantly increased macular thickness. PVA, except lamellar holes, disappeared or decrease in severity after ERM and ILM removal surgery.
Different types of PVA are relatively common in eyes with ERM. Our findings suggest that PVA may develop secondary to ERM-induced macular thickening. Except for lamellar holes, most lesions decrease following an operation.
研究视网膜血管弓周围的血管旁异常(PVA)及其在视网膜前膜(ERM)患者眼中的术后演变情况。
这是一个观察性病例系列研究。对55例同时患有PVA和ERM的患者的57只眼进行了研究(研究组)。41例患有ERM但无PVA的患者的41只眼作为对照组。对每位患者沿上下血管弓并穿过黄斑进行多次光学相干断层扫描(OCT)。对接受手术的眼睛进行系列眼底照相和OCT扫描。所有手术均由一名外科医生进行。确定血管旁视网膜囊肿、血管下方的深部囊性间隙、血管旁视网膜缺损的发生率和位置,以及玻璃体视网膜界面变化,并将其与黄斑厚度相关联。
在研究组中,57只眼中均检测到血管旁视网膜囊肿(100%),9只眼中检测到深部囊性间隙(15.8%),31只眼中检测到血管旁板层孔(54.4%)。无全层孔病例。16只眼(28.1%)观察到ERM与PVA粘连,22只眼(38.6%)观察到PVA上方的内界膜(ILM)变化。与对照组相比,研究组黄斑厚度显著增加。除板层孔外,PVA在ERM和ILM切除术后消失或严重程度降低。
不同类型的PVA在患有ERM的眼中相对常见。我们的研究结果表明,PVA可能继发于ERM引起的黄斑增厚。除板层孔外,大多数病变在手术后减轻。