Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Retina. 2018 Nov;38(11):2118-2127. doi: 10.1097/IAE.0000000000001831.
To investigate postoperative changes and prognostic factors of visual impairment after vitrectomy for unilateral epiretinal membrane.
A prospective observational study on 45 eyes from 45 patients with unilateral idiopathic epiretinal membrane who underwent vitrectomy. Visual parameters (best-corrected visual acuity, metamorphopsia using M-CHARTS, and aniseikonia using the New Aniseikonia Test) and spectral domain optical coherence tomography parameters (macular retinal layer thickness and microstructure of the outer retina) were measured preoperatively and 6 and 12 months postoperatively. Statistical analyses included linear mixed-effects models for the longitudinal changes and prognostic factors of visual parameters.
Best-corrected visual acuity and horizontal metamorphopsia improved significantly from 6 months after surgery (P < 0.001), whereas aniseikonia decreased significantly only at 12 months (P = 0.015). Vertical metamorphopsia remained unchanged. Preoperative inner nuclear layer thickness was significantly correlated with preoperative metamorphopsia. Besides baseline values, best-corrected visual acuity had no significant prognostic factors, but preoperative ellipsoid zone disruption had a negative direction of association with postoperative metamorphopsia (coefficients: -0.37 and -0.62, P = 0.015 and 0.006 for horizontal and vertical metamorphopsia, respectively), and preoperative horizontal metamorphopsia had a positive direction of association with postoperative aniseikonia (coefficient: 1.77, P = 0.002).
After vitrectomy, postoperative changes and prognostic factors for unilateral epiretinal membrane differed for best-corrected visual acuity, metamorphopsia, and aniseikonia.
研究单侧视网膜内界膜后发性白内障玻璃体切除术后视力障碍的术后变化和预后因素。
对 45 例（45 只眼）特发性单侧视网膜内界膜后发性白内障患者进行前瞻性观察研究，行玻璃体切除术。术前及术后 6 个月和 12 个月测量视力参数（最佳矫正视力、M-CHARTS 测量的变形视、新变视测试的不等像）和光谱域光学相干断层扫描参数（黄斑视网膜层厚度和外视网膜微观结构）。统计分析包括线性混合效应模型，用于视觉参数的纵向变化和预后因素。
术后 6 个月，最佳矫正视力和水平变形视明显改善（P < 0.001），而不等像仅在 12 个月时显著降低（P = 0.015）。垂直变形视保持不变。术前内核层厚度与术前变形视显著相关。除了基线值外，最佳矫正视力没有显著的预后因素，但术前椭圆体带破坏与术后变形视呈负相关（水平和垂直变形视的系数分别为-0.37 和-0.62，P = 0.015 和 0.006），术前水平变形视与术后不等像呈正相关（系数：1.77，P = 0.002）。
玻璃体切除术后，单侧视网膜内界膜后发性白内障的术后变化和预后因素在最佳矫正视力、变形视和不等像方面存在差异。
