Department of Retinal & Vitreous Diseases, Chongqing Aier-Mega Eye Hospital, Aier Medical Group, 288 Nanchen Street, Chongqing, 400060, People's Republic of China.
BMC Ophthalmol. 2020 Mar 4;20(1):83. doi: 10.1186/s12886-020-01354-8.
The aim of this study was to compare the anatomical and visual outcomes of vitrectomy with or without internal limiting membrane (ILM) peeling for symptomatic myopic foveoschisis (MF).
A retrospective cohort study of patients who had undergone vitrectomy for symptomatic MF at our specialist ophthalmology department in China. Cases were retrospectively categorized into one of two cohorts, depending on whether or not they had undergone ILM peeling (ILMP) during their surgery. Over a mean follow-up period of 18 months, all eyes underwent repeated examinations, including best-corrected visual acuity (BCVA) and optical coherence tomographic (OCT) recordings, particularly focusing on central foveal thickness (CFT), macular hole (MH) formation and/or foveal detachment (FD).
We included 32 eyes (32 patients) with mean age of 62.2 ± 7.4 years. 31 patients (96.8%) were female. There were 21 eyes in the ILMP cohort and 11 eyes in the non-ILMP cohort. There were no significant preoperative differences in age, axial length, symptom duration or postoperative follow-up period between the two cohorts. MF was resolved completely in all of the eyes except one eye in the ILMP cohort. The postoperative CFT was significantly reduced compared to the preoperative baseline in both cohorts (469 ± 203 μm to 253 ± 56 μm; p = 0.003 in no-ILMP; 495 ± 178 μm to 244 ± 63 μm; p < 0.001 in ILMP, respectively). The final BCVA improved significantly in non-ILMP (1.27 ± 0.63 logMAR to 0.73 ± 0.55 logMAR; p = 0.021); but not significantly in ILMP cohort (1.25 ± 0.51 to 0.98 ± 0.57 logMAR; p = 0.143).
Vitrectomy, either with or without ILM peeling, results in a significant anatomical improvement in eyes with MF. Eyes treated by vitrectomy may have a better visual improvement when ILM was not peeled.
本研究旨在比较玻璃体切割术联合或不联合内界膜（ILM）剥除治疗症状性近视性黄斑劈裂（MF）的解剖学和视觉结果。
本研究为中国某眼科专科医院进行的回顾性队列研究，纳入了接受玻璃体切割术治疗症状性 MF 的患者。根据手术中是否进行 ILM 剥除（ILMP），将病例分为两组。在平均 18 个月的随访期间，所有患者均接受了多次检查，包括最佳矫正视力（BCVA）和光学相干断层扫描（OCT）记录，特别关注中心凹视网膜厚度（CFT）、黄斑裂孔（MH）形成和/或中心凹脱离（FD）。
共纳入 32 只眼（32 例），平均年龄为 62.2±7.4 岁，31 例（96.8%）为女性。ILMP 组 21 只眼，非 ILMP 组 11 只眼。两组间患者年龄、眼轴长度、症状持续时间和术后随访时间无显著差异。除 ILMP 组 1 只眼外，所有患者的 MF 均完全消退。两组术后 CFT 均较术前明显降低（非 ILMP 组：469±203μm 至 253±56μm；p=0.003；ILMP 组：495±178μm 至 244±63μm；p<0.001）。非 ILMP 组最终 BCVA 明显改善（1.27±0.63 logMAR 至 0.73±0.55 logMAR；p=0.021），而 ILMP 组则无明显改善（1.25±0.51 至 0.98±0.57 logMAR；p=0.143）。
玻璃体切割术联合或不联合 ILM 剥除均可显著改善 MF 患者的解剖学结果。未行 ILM 剥除的玻璃体切割术治疗眼视力改善可能更好。
