Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Department of Ophthalmology, Inagi Municipal Hospital, Tokyo, Japan.
Sci Rep. 2019 Dec 13;9(1):19056. doi: 10.1038/s41598-019-55544-6.
We evaluated predictive factors for visual outcomes in patients with idiopathic epiretinal membrane (iERM) after pars plana vitrectomy (PPV). Clinical records for 114 eyes (114 patients, mean age: 70.6 years) with iERM treated by PPV between March 2012 and March 2018 were retrospectively reviewed. Overall, the mean postoperative best-corrected visual acuity (BCVA) and central retinal thickness measured by optical coherence tomography improved as early as 1 month after surgery, and further improved until 3 months (P < 0.01). Multiple linear regression analyses adjusted for the preoperative BCVA showed that older age (B, 0.010; 95% confidence interval, 0.003 to 0.016; P = 0.003) and a shorter axial length (AL; B, -0.059; 95% confidence interval, -0.099 to -0.019; P = 0.005) predicted worse postoperative BCVA. The Mann-Whitney U test showed that the postoperative BCVA was worse in eyes with AL < 23.6 mm than in eyes with AL ≥ 23.6 mm (P = 0.037), and in patients aged ≥69 years than in patients aged <69 years (P = 0.024). The findings may help in evaluating surgical indications for each patient to obtain satisfactory outcomes, irrespective of the preoperative BCVA.
我们评估了特发性视网膜前膜（iERM）患者经玻璃体切除术（PPV）后的视觉预后的预测因素。回顾性分析了 2012 年 3 月至 2018 年 3 月期间接受 PPV 治疗的 114 只眼（114 例患者，平均年龄：70.6 岁）的临床记录。总的来说，术后最佳矫正视力（BCVA）和光学相干断层扫描测量的中心视网膜厚度在术后 1 个月内即可早期改善，并且直到 3 个月时仍在进一步改善（P<0.01）。多元线性回归分析校正术前 BCVA 后显示，年龄较大（B，0.010；95%置信区间，0.003 至 0.016；P=0.003）和眼轴（AL）较短（B，-0.059；95%置信区间，-0.099 至-0.019；P=0.005）预测术后 BCVA 较差。Mann-Whitney U 检验显示，AL<23.6mm 的眼术后 BCVA 较 AL≥23.6mm 的眼差（P=0.037），69 岁及以上患者的术后 BCVA 较<69 岁患者差（P=0.024）。这些发现可能有助于评估每位患者的手术适应证，以获得满意的结果，而与术前 BCVA 无关。
