Lee Jang Hoon, Park Sung Pyo, Kim Yong Kyu
Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2017 Dec;31(6):508-513. doi: 10.3341/kjo.2017.0021. Epub 2017 Nov 15.
To evaluate the association between degree of retinal abnormalities and uncorrected visual acuity (UCVA) in idiopathic epiretinal membrane (ERM) patients with a small amount of refractive error.
We retrospectively reviewed 49 eyes (37 patients) of idiopathic ERM patients. We investigated the association between visual acuity and macular status (central macular thickness [CMT], outer retinal integrity score, and inner retinal irregularity index) that was assessed by optical coherence tomography using multiple linear regression analysis. We defined visual acuity difference (VAD) as the difference between UCVA and best-corrected visual acuity (BCVA). We divided patients into two groups according to VAD size and compared clinical characteristics between the two groups. We also investigated factors associated with VAD using multiple linear regression analysis.
BCVA showed significant association with CMT and outer retinal integrity score, while UCVA showed significant association with CMT and inner retinal irregularity index. Patients with a large VAD showed a similar level of BCVA compared to the small VAD group (logarithm of the minimum angle of resolution [logMAR], large VAD group 0.11 ± 0.11 vs. small VAD group 0.13 ± 0.12, p = 0.585). However, UCVA was worse (logMAR, large VAD group 0.44 ± 0.14 vs. small VAD group 0.18 ± 0.14, p < 0.001) and inner retinal irregularity was higher (large VAD group 1.06 ± 0.04 vs. small VAD group 1.04 ± 0.03, p < 0.001) in patients with a large VAD. On multiple linear regression analysis, the absolute value of spherical equivalent (standardized coefficient β 0.521, p < 0.001) and inner retinal irregularity index (standardized coefficient β 0.448, p < 0.001) were significantly associated with VAD.
UCVA was associated with inner retinal irregularity in idiopathic ERM patients with a mild degree of refractive error. Inner retinal irregularity was also associated with degree of VAD, suggesting that the effect of refractive error correction is greater in patients with more distorted retina.
评估少量屈光不正的特发性视网膜前膜（ERM）患者视网膜异常程度与未矫正视力（UCVA）之间的关联。
我们回顾性分析了49例（49只眼）特发性ERM患者。通过光学相干断层扫描评估视力与黄斑状态（中心黄斑厚度[CMT]、视网膜外层完整性评分和视网膜内层不规则指数）之间的关联，并采用多元线性回归分析。我们将视力差异（VAD）定义为UCVA与最佳矫正视力（BCVA）之间的差值。根据VAD大小将患者分为两组，并比较两组之间的临床特征。我们还采用多元线性回归分析研究与VAD相关的因素。
BCVA与CMT和视网膜外层完整性评分显著相关，而UCVA与CMT和视网膜内层不规则指数显著相关。VAD大的患者与VAD小的患者相比，BCVA水平相似（最小分辨角对数[logMAR]，VAD大的组为0.11±0.11，VAD小的组为0.13±0.12，p = 0.585）。然而，VAD大的患者UCVA更差（logMAR，VAD大的组为0.44±0.14，VAD小的组为0.18±0.14，p < 0.001），视网膜内层不规则性更高（VAD大的组为1.06±0.04，VAD小的组为1.04±0.03，p < 0.001）。多元线性回归分析显示，等效球镜绝对值（标准化系数β 0.521，p < 0.001）和视网膜内层不规则指数（标准化系数β 0.448，p < 0.001）与VAD显著相关。
在少量屈光不正的特发性ERM患者中，UCVA与视网膜内层不规则性相关。视网膜内层不规则性也与VAD程度相关，这表明在视网膜扭曲更严重的患者中，屈光不正矫正的效果更大。
