Romano Mario R, Cennamo Gilda, Amoroso Francesca, Montorio Daniela, Castellani Carlo, Reibaldi Michele, Cennamo Giovanni
Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Via Pansini 5, 80131, Naples, Italy.
Humanitas Research Hospital, Via Manzoni 56, Rozzano, MI, Italy.
Graefes Arch Clin Exp Ophthalmol. 2017 Jan;255(1):31-38. doi: 10.1007/s00417-016-3413-z. Epub 2016 Jun 23.
To determine the correlation between the area of morphological changes on the macular surface, the depth of intraretinal changes and the best-corrected visual acuity (BCVA) in patients with idiopathic epiretinal membrane.
In this prospective cross-sectional study, 38 patients underwent BCVA testing with a Snellen eye chart. The depth of traction, photoreceptor outer segment layer (PROS) thickness, central macular thickness (CMT) and presence of intraretinal cysts were measured using the Avanti RTVue XR and 3D Widefield Enface OCT instruments. Enface sections were performed at the inner limiting membrane (ILM) line level (ILM offset). Patients were categorized into two groups: in group 1 (n = 21), the depth of traction was within 90 μm from the ILM, and in group 2 (n = 17) it was beyond 90 μm from the ILM. The main outcome measure was the correlation between area of epiretinal traction and BCVA according to the depth of traction.
In group 1, the depth of traction was 55.15 ± 14.28 μm, the area of traction was 38.95 ± 13.63 mm, PROS thickness was 51.20 ± 7.23 μm, and CMT was 362.65 ± 41.08 μm. In group 2, the depth of traction was 112.24 ± 10.89 μm, the area of traction was 25.18 ± 4.07 mm, PROS thickness was 50.24 ± 9.01 μm, and mean CMT was 534.29 ± 126.81 μm. Statistically significant differences in depth of traction, area of traction and CMT were found between the two groups (P < 0.001). The relationship between structure and function between the area of traction and BCVA was better explained in group 2 (r = 0.814, P < 0.001).
We found that intraretinal changes were induced by the ERM, and varied according to the depth of traction measured with en face analysis. In the case of traction deeper than 90 μm, we found a significant correlation between the inner area of the epiretinal traction and BCVA. We believe that retinal stress induced by epiretinal traction is better characterized by combining information provided by sagittal and transverse OCT scans, thus defining its prognostic significance in ERM.
确定特发性视网膜前膜患者黄斑表面形态学改变的面积、视网膜内改变的深度与最佳矫正视力（BCVA）之间的相关性。
在这项前瞻性横断面研究中，38例患者使用斯内伦视力表进行了BCVA测试。使用Avanti RTVue XR和3D宽视野视网膜断层扫描（OCT）仪器测量牵引深度、光感受器外节层（PROS）厚度、中心黄斑厚度（CMT）以及视网膜内囊肿的存在情况。在视网膜内界膜（ILM）线水平（ILM偏移）进行视网膜断层扫描横断面成像。患者被分为两组：第1组（n = 21），牵引深度在距ILM 90μm以内；第2组（n = 17），牵引深度在距ILM 90μm以外。主要观察指标是根据牵引深度，视网膜前牵引面积与BCVA之间的相关性。
第1组中，牵引深度为55.15±14.28μm，牵引面积为38.95±13.63mm，PROS厚度为51.20±7.23μm，CMT为362.65±41.08μm。第2组中，牵引深度为112.24±10.89μm，牵引面积为25.18±4.07mm，PROS厚度为50.24±9.01μm，平均CMT为�34.29±126.81μm。两组之间在牵引深度、牵引面积和CMT方面存在统计学显著差异（P < 0.001）。第2组中牵引面积与BCVA之间的结构与功能关系得到了更好的解释（r = 0.814，P < 0.001）。
我们发现视网膜前膜会引起视网膜内改变，且根据视网膜断层扫描横断面分析测量的牵引深度而有所不同。在牵引深度超过90μm的情况下，我们发现视网膜前牵引的内部区域与BCVA之间存在显著相关性。我们认为，通过结合矢状面和横断面OCT扫描提供的信息，可以更好地描述视网膜前牵引引起的视网膜应力，从而确定其在视网膜前膜中的预后意义。
