Paul Christoph, Heun Christine, Müller Hans H, Fauser Sascha, Kaymak Hakan, Kazerounian Sara, Sekundo Walter, Mennel Stefan, Meyer Carsten H, Schmitz-Valckenberg Steffen, Koss Michael J, Feltgen Nicolas, Bertelmann Thomas
*Department of Ophthalmology, Philipps-University Marburg, Germany; †Institute of Medical Biometry and Epidemiology, Philipps-University Marburg, Marburg, Germany; ‡Department of Ophthalmology, University of Cologne, Cologne, Germany; §Internationale Innovative Ophthalmochirurgie (IIO), Düsseldorf, Germany; ¶Department of Ophthalmology, Knappschaftskrankenhaus Sulzbach, Sulzbach, Germany; **Department of Ophthalmology, Feldkirch State Hospital, Feldkirch, Austria; ††Department of Ophthalmology, Pallas Clinic, Aarau, Switzerland; ‡‡Department of Ophthalmology, Rheinische Friedrich-Wilhelms-University, Bonn, Germany; §§Department of Ophthalmology, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany; and ¶¶Department of Ophthalmology, University Medical Center Goettingen, Goettingen, Germany.
Retina. 2017 Jul;37(7):1252-1260. doi: 10.1097/IAE.0000000000001371.
To evaluate the impact of the vitreoretinal interface architecture, in specific the angle between the posterior vitreous cortex and the internal limiting membrane, on vitreomacular traction (VMT) resolution in eyes treated with intravitreally injected ocriplasmin (Jetrea).
Retrospective, multicenter cohort study and exploratory data analysis. Spectral domain optical coherence tomography assessments were performed before scheduled ocriplasmin injections. General (age and sex) as well as ocular variables (lens status, presence of epiretinal membrane formations, horizontal diameter of VMT, central retinal thickness, and in particular various prespecified angles between the posterior vitreous cortex and internal limiting membrane) were analyzed to evaluate their impact on successful VMT resolution.
Fifty-nine eyes of 59 patients were included. Univariate analysis of age (odds ratio [OR]: 0.881; 95% CI: [0.812-0.955]; P = 0.0022) and lens status (OR: 11.03; 95% CI: [2.23-54.57]; P = 0.0033) had a significant impact on successful VMT resolution, whereas sex (OR: 0.668; 95% CI: [0.126-2.065]; P = 0.4906), epiretinal membrane formation (OR: 0.581; 95% CI: [0.168-2.006]; P = 0.3903), horizontal diameter of VMT (OR: 0.99930; 95% CI: [0.99825-1.00035]; P = 0.1886), and central retinal thickness (OR: 0.9985; 95% CI: [0.9934-1.00436]; P = 0.56) failed. The angle at 500 μm apart from the fovea centralis, irrespective if measured nasally (OR: 1.135; 95% CI: [1.013-1.272]; P = 0.0289) or temporally (OR: 1.099; 95% CI: [1.001-1.208]; P = 0.0485), showed a significant correlation with VMT resolution.
The angle between the posterior vitreous cortex and the internal limiting membrane 500 μm apart from the fovea centralis correlates with VMT resolution and may be a clinically useful marker for selection of patients to be treated with ocriplasmin. This observation needs to be proven in a prospective confirmatory investigation.
评估玻璃体视网膜界面结构，特别是玻璃体后皮质与内界膜之间的夹角，对玻璃体内注射奥克纤溶酶（Jetrea）治疗的眼中玻璃体黄斑牵引（VMT）消退的影响。
回顾性多中心队列研究及探索性数据分析。在预定的奥克纤溶酶注射前进行光谱域光学相干断层扫描评估。分析一般变量（年龄和性别）以及眼部变量（晶状体状态、视网膜前膜形成情况、VMT的水平直径、中心视网膜厚度，特别是玻璃体后皮质与内界膜之间的各种预先设定的夹角），以评估它们对VMT成功消退的影响。
纳入59例患者的59只眼。年龄的单因素分析（比值比[OR]：0.881；95%置信区间[CI]：[0.812 - 0.955]；P = 0.0022）和晶状体状态（OR：11.03；95% CI：[2.23 - 54.57]；P = 0.0033）对VMT成功消退有显著影响，而性别（OR：0.668；95% CI：[0.126 - 2.065]；P = 0.4906）、视网膜前膜形成（OR：0.581；95% CI：[0.168 - 2.006]；P = 0.3903）、VMT的水平直径（OR：0.99930；95% CI：[0.99825 - 1.00035]；P = 0.1886）和中心视网膜厚度（OR：0.9985；95% CI：[0.9934 - 1.00436]；P = 0.56）则无影响。距黄斑中心凹500μm处的夹角，无论从鼻侧测量（OR：1.135；95% CI：[1.013 - 1.272]；P = 0.0289）还是颞侧测量（OR：1.099；95% CI：[1.001 - 1.208]；P = 0.0485），均与VMT消退显著相关。
玻璃体后皮质与距黄斑中心凹500μm处的内界膜之间的夹角与VMT消退相关，可能是选择接受奥克纤溶酶治疗患者的临床有用指标。这一观察结果需要在前瞻性验证性研究中得到证实。
