Mao Jianbo, Wu Hanfei, Liu Chenyi, Zhu Chenting, Lao Jimeng, Chen Yiqi, Tao Jiwei, Zhang Yun, Shen Lijun
Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang Province, China.
The People's Hospital of Zhuji, Zhuji, Zhejiang Province, China.
J Ophthalmol. 2019 Jun 17;2019:7931654. doi: 10.1155/2019/7931654. eCollection 2019.
To observe the changes in metamorphopsia, visual acuity, and central macular thickness (CMT) in patients undergoing vitrectomy for idiopathic epiretinal membranes (iERM); all of which were preoperatively stratified into 4 stages according to the anatomical structure of the macula seen on the optical coherence tomography (OCT) b-scan images.
A total of 108 eyes of 106 patients were included. We evaluated and classified the severity of each preoperative ERM based on OCT. Changes in the best-corrected visual acuity (BCVA), metamorphopsia, and CMT were studied by comparing the pre- and postoperative measurements. The follow-up time was at least 6 months.
There were 41 eyes at stage 2, 35 at stage 3, 32 at stage 4, and none at stage 1. BCVA and metamorphopsia significantly improved at the final visit in all patients ( < 0.01). However, comparing the pre- and postoperative measurements at each stage, only the BCVA and CMT improved significantly for all stages ( < 0.001). For stages 2 and 3 ERMs, the horizontal (MH) and vertical (MV) metamorphopsia scores decreased significantly after surgery ( < 0.05). No significant difference was found in either MH or MV for stage 4 ERMs ( both >0.05). The preoperative BCVA, MH, and CMT had significant difference among the three stages ( < 0.05). Similarly, the postoperative values in the three variables mentioned above also had significant difference among the three stages ( < 0.05). For stage 2 ERMs, the baseline MH and MV were positively correlated with the baseline CMT. The MH and MV at the final follow-up also presented a significant positive correlation with the baseline CMT. For stage 3 ERMs, only the baseline MV showed significant correlation with the CMT.
Categorization of the preoperative ERMs is a useful method to predict the postoperative improvement in metamorphopsia, which would aid in surgical decisions for patients with ERMs.
观察接受玻璃体切除术治疗特发性视网膜前膜（iERM）患者的视物变形、视力及黄斑中心厚度（CMT）的变化；所有患者术前均根据光学相干断层扫描（OCT）B 扫描图像上所见黄斑的解剖结构分为 4 个阶段。
纳入 106 例患者的 108 只眼。我们根据 OCT 评估并分类每个术前 ERM 的严重程度。通过比较术前和术后测量值研究最佳矫正视力（BCVA）、视物变形和 CMT 的变化。随访时间至少 6 个月。
2 期有 41 只眼，3 期有 35 只眼，4 期有 32 只眼，1 期无。所有患者末次随访时 BCVA 和视物变形均显著改善（<0.01）。然而，比较各阶段术前和术后测量值，仅各阶段的 BCVA 和 CMT 显著改善（<0.001）。对于 2 期和 3 期 ERM，术后水平（MH）和垂直（MV）视物变形评分显著降低（<0.05）。4 期 ERM 的 MH 或 MV 均未发现显著差异（均>0.05）。术前 BCVA、MH 和 CMT 在三个阶段之间存在显著差异（<0.05）。同样，上述三个变量的术后值在三个阶段之间也存在显著差异（<0.05）。对于 2 期 ERM，基线 MH 和 MV 与基线 CMT 呈正相关。末次随访时的 MH 和 MV 与基线 CMT 也呈显著正相关。对于 3 期 ERM，仅基线 MV 与 CMT 显示出显著相关性。
术前 ERM 的分类是预测术后视物变形改善情况的有用方法，这将有助于 ERM 患者的手术决策。
