Department of Ophthalmology and Vision Sciences, Eye Care Centre, University of British Columbia, Vancouver, British Columbia, Canada.
Retina Division, Oftalmico Hospital, ASST-Fbf-Sacco, Milan, Italy.
Retina. 2020 Mar;40(3):557-566. doi: 10.1097/IAE.0000000000002432.
To quantitatively and qualitatively evaluate the microvascular and structural abnormalities associated with inner retinal dimpling after internal limiting membrane peeling for full-thickness macular holes using sequential en face optical coherence tomography (OCT) and OCT angiography.
Thirteen eyes of 13 patients with idiopathic full-thickness macular holes were enrolled in the study. Patients were treated with pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade. Subjects were evaluated preoperatively and at postoperative Months 1, 3, and 6. At each visit, patients underwent a comprehensive ophthalmologic examination, en face OCT and OCT angiography. The morphology and number and proportionate area of inner retinal dimples were analyzed. Vessel density of the superficial vascular complex at all visits was also measured.
Inner retinal dimples were identified 1 month after surgery in all cases. The number and proportionate area of inner retinal dimples significantly increased over the follow-up period (P = 0.05). Preoperative vessel density of the superficial vascular complex was 17.9 ± 1.9 and did not change significantly over the follow-up period (P = 0.15).
Inner retinal dimples are identified with en face OCT as early as the first month after internal limiting membrane peeling for idiopathic full-thickness macular holes and progressively increase in number and proportionate area in the subsequent 3 to 6 months after surgery. This may be the result of progressive deturgescence of the nerve fiber layer in the postoperative period.
使用序贯的光学相干断层扫描(OCT)和 OCT 血管造影术,定量和定性评估完全性黄斑裂孔内界膜剥离术后与内视网膜陷窝相关的微血管和结构异常。
本研究纳入了 13 例特发性全层黄斑裂孔患者的 13 只眼。患者接受了经睫状体平坦部玻璃体切除术、内界膜剥离术和气体填充术治疗。患者在术前和术后 1、3 和 6 个月进行评估。每次就诊时,患者均接受全面眼科检查、OCT 以及 OCT 血管造影。分析内视网膜陷窝的形态、数量和比例面积。还测量了所有就诊时浅层血管复合体的血管密度。
所有病例均在术后 1 个月发现内视网膜陷窝。在随访期间,内视网膜陷窝的数量和比例面积显著增加(P = 0.05)。浅层血管复合体的术前血管密度为 17.9 ± 1.9,在随访期间没有明显变化(P = 0.15)。
在特发性全层黄斑裂孔内界膜剥离术后的第一个月,就可以使用 OCT 进行检查发现内视网膜陷窝,并且在术后 3 至 6 个月内,其数量和比例面积逐渐增加。这可能是术后神经纤维层逐渐脱水的结果。