Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
Graefes Arch Clin Exp Ophthalmol. 2020 Apr;258(4):743-749. doi: 10.1007/s00417-020-04625-8. Epub 2020 Feb 21.
To investigate stereopsis and other visual functions in patients with unilateral epiretinal membrane (ERM) and to identify vision-related parameters affecting stereopsis.
This prospective study included 63 consecutive patients who were scheduled to undergo vitrectomy for unilateral idiopathic ERM. We examined stereopsis (Titmus Stereo Test, TST; TNO stereotest, TNO), best-corrected visual acuity (BCVA), letter contrast sensitivity, severity of metamorphopsia, and degree of aniseikonia preoperatively and 6 months postoperatively.
Preoperatively, we observed significant correlation between TST scores and other vision-related parameters except severity of metamorphopsia and between TNO score and all the vision-related parameters. Multiple regression analysis showed that preoperative TST and TNO scores were significantly associated with the degree of aniseikonia (both P < 0.01). ERM surgery significantly improved stereopsis, BCVA, contrast sensitivity, and metamorphopsia, but not aniseikonia. Postoperatively, TST was significantly associated with BCVA, and TNO showed association with BCVA and aniseikonia. Postoperative TST and TNO scores showed significant correlation with preoperative aniseikonia (P < 0.005 and P < 0.001, respectively).
Impairment of stereopsis in patients with unilateral ERM was considered to be due to retinally induced aniseikonia. Aniseikonia did not improve by surgery, and preoperative aniseikonia can be a prognostic factor for postoperative stereopsis.
研究单侧视网膜前膜(ERM)患者的立体视功能和其他视觉功能,并确定影响立体视的视力相关参数。
本前瞻性研究纳入了 63 例连续接受玻璃体切除术治疗单侧特发性 ERM 的患者。我们术前和术后 6 个月检查了立体视(Titmus 立体测试,TST;TNO 立体测试,TNO)、最佳矫正视力(BCVA)、字母对比度敏感度、变视症严重程度和三棱镜差异。
术前,我们观察到 TST 评分与其他视力相关参数(除变视症严重程度外)和 TNO 评分与所有视力相关参数之间均存在显著相关性。多元回归分析显示,术前 TST 和 TNO 评分与三棱镜差异程度显著相关(均 P < 0.01)。ERM 手术显著改善了立体视、BCVA、对比度敏感度和变视症,但不能改善三棱镜差异。术后,TST 与 BCVA 显著相关,TNO 与 BCVA 和三棱镜差异相关。术后 TST 和 TNO 评分与术前三棱镜差异显著相关(P < 0.005 和 P < 0.001)。
单侧 ERM 患者立体视功能障碍被认为是由于视网膜引起的三棱镜差异所致。手术不能改善三棱镜差异,术前三棱镜差异可以作为术后立体视的预后因素。