Sato Tatsuhiko, Mori Reina, Takahashi Shinya, Yoshimura Koichi, Hirata Akira, Manabe Shin-Ichi, Hayashi Ken
Hayashi Eye Hospital, 4-23-35 Hakataekimae Hakata-ku, Fukuoka, 812-0011, Japan.
Graefes Arch Clin Exp Ophthalmol. 2019 Sep;257(9):1823-1829. doi: 10.1007/s00417-019-04376-1. Epub 2019 Jun 1.
To investigate the anatomical and functional changes in areas containing paravascular abnormalities (PVA) in eyes with epiretinal membrane (ERM) after surgery.
Twenty-eight eyes with concurrent idiopathic ERM and PVA were enrolled in this prospective study. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and areas of PVA in the superficial and deep capillary levels detected on en face optical coherence tomography were measured preoperatively and 1, 3, and 6 months postoperatively. Retinal sensitivity in selected PVA lesions was evaluated by microperimetry preoperatively and 1 and 6 months postoperatively.
The areas of PVA at the superficial capillary level before and 1, 3, and 6 months after surgery measured 1.65 ± 1.27, 0.44 ± 0.62, 0.40 ± 0.64, and 0.38 ± 0.62 mm, respectively, while those at the deep capillary level measured 0.27 ± 0.57, 0.10 ± 0.26, 0.09 ± 0.29, and 0.05 ± 0.15 mm, respectively. The areas of PVA in the superficial and deep capillary levels were significantly smaller postoperatively (all p < 0.001 at the superficial capillary level and p = 0.010 at the deep capillary level). Average retinal sensitivity values in the PVA lesions before and 1 and 6 months after surgery were 11.2 ± 3.5, 12.9 ± 3.2, and 13.2 ± 2.7 dB, respectively; the values at postoperative months 1 and 6 were significantly improved (p = 0.045 and p < 0.001, respectively). BCVA and CMT were significantly improved postoperatively.
PVA not only improves anatomically but also functionally after ERM surgery. Vitrectomy can improve not only central vision but also retinal sensitivity in areas of PVA.
研究视网膜前膜(ERM)手术后眼部血管周围异常(PVA)区域的解剖学和功能变化。
本前瞻性研究纳入了28例同时患有特发性ERM和PVA的患者。术前及术后1、3和6个月测量最佳矫正视力(BCVA)、中心黄斑厚度(CMT)以及通过正面光学相干断层扫描检测到的浅层和深层毛细血管水平的PVA区域。术前及术后1和6个月通过微视野检查评估选定PVA病变处的视网膜敏感度。
手术前、术后1、3和6个月,浅层毛细血管水平的PVA区域分别为1.65±1.27、0.44±0.62、0.40±0.64和0.38±0.62mm,而深层毛细血管水平的PVA区域分别为0.27±0.57、0.10±0.26、0.09±0.29和0.05±0.15mm。术后浅层和深层毛细血管水平的PVA区域均显著减小(浅层毛细血管水平所有p<0.001,深层毛细血管水平p = 0.010)。PVA病变处术前、术后1和6个月的平均视网膜敏感度值分别为11.2±3.5、12.9±3.2和13.2±2.7dB;术后1个月和6个月的值显著改善(分别为p = 0.045和p<0.001)。术后BCVA和CMT显著改善。
ERM手术后PVA不仅在解剖学上得到改善,在功能上也得到改善。玻璃体切除术不仅可以改善中心视力,还可以改善PVA区域的视网膜敏感度。