Retina Division, Stein Eye Institute, University of California, Los Angeles, Los Angeles, California.
Ophthalmology Unit, Fatebenefratelli and Oftalmico Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
Retina. 2019 Feb;39(2):347-357. doi: 10.1097/IAE.0000000000001940.
To describe the functional and anatomical outcomes of pars plana vitrectomy with epiretinal membrane and internal limiting membrane peel in eyes with and without ectopic inner foveal layers (EIFLs).
In this retrospective multicenter study, patients diagnosed with idiopathic epiretinal membranes who underwent pars plana vitrectomy with epiretinal membrane and internal limiting membrane peel were enrolled, with a minimum follow-up of 12 months. Preoperative and postoperative spectral domain optical coherence tomography scans were qualitatively and quantitatively evaluated. The association of the EIFL and other spectral domain optical coherence tomography parameters with preoperative and postoperative best-corrected visual acuity (BCVA) was analyzed.
One hundred eleven eyes of 107 patients were included. Preoperatively, the EIFLs were present in 56 of 111 eyes (50.4%). The presence of EIFL was significantly associated with lower preoperative and postoperative BCVA (P < 0.001). Ectopic inner foveal layer thickness was negatively correlated with preoperative BCVA (r = 0.58, P < 0.001). Postoperatively, the EIFL persisted in 51 of 56 eyes (91%) with Stage 3 and 4 epiretinal membranes. Ectopic inner foveal layer thickness decreased significantly after surgery (P < 0.001), but postoperative EIFL thinning had no direct effect on postoperative change in BCVA. At 12 months from surgery, EIFL thickness maintained a significant negative correlation with BCVA (r = 0.55, P < 0.001).
The presence of EIFL should be considered a negative prognostic factor for postoperative anatomical and functional recovery.
描述合并和不合并异位中心凹内层（EIFL）的孔源性视网膜前膜患者行玻璃体切除联合内界膜剥除术后的功能和解剖学结果。
在这项回顾性多中心研究中，纳入了诊断为特发性视网膜前膜且接受玻璃体切除联合内界膜剥除术的患者，这些患者的随访时间至少为 12 个月。对术前和术后的频域光学相干断层扫描进行定性和定量评估。分析 EIFL 与其他频域光学相干断层扫描参数与术前和术后最佳矫正视力（BCVA）的关系。
111 只眼（107 例患者）纳入研究。术前，56 只眼（50.4%）存在 EIFL。EIFL 的存在与术前和术后 BCVA 较低显著相关（P<0.001）。EIFL 厚度与术前 BCVA 呈负相关（r=0.58，P<0.001）。术后，56 只眼（91%）中存在 3 期和 4 期视网膜前膜的 EIFL 持续存在。术后 EIFL 厚度显著减少（P<0.001），但 EIFL 变薄对术后 BCVA 的改变没有直接影响。术后 12 个月，EIFL 厚度与 BCVA 仍呈显著负相关（r=0.55，P<0.001）。
EIFL 的存在应被视为术后解剖和功能恢复的负面预后因素。
