Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaomminxiang Street, Dongcheng District, Beijing, 100730, China.
Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab; Beijing Tongren Hospital, Capital Medical University, Beijing, China.
BMC Ophthalmol. 2020 Apr 9;20(1):140. doi: 10.1186/s12886-020-01383-3.
To evaluate the effect of internal limiting membrane (ILM) peeling surrounding macular holes (MH) for the function of retina by microperimetry-3(MP-3).
This is a prospective, cohort study which included patients with MHs who were treated by 23-gauge 3-port pars plana vitrectomy and ILM peeling with air tamponade. Color fundus photography, retinal optical coherence tomography and MP-3 were performed 1 week before, 1 and 4 months after the operation. In MP-3 examination, a customized follow-up pattern with 45 spots in the central 8° visual field was used. The spots corresponding to the retina surrounding macular holes were selected for comparison of pre- and post-operative function.
We incuded 44 eyes of 44 patients with best corrected visual acuity (BCVA) of 1.06 ± 0.40 (logMAR). All eyes achieved an anatomical success at 4 months. BCVA significantly improved at 1 month (0.53 ± 0.30, P < 0.01) and 4 months (0.31 ± 0.24, P < 0.01), respectively. Mean retinal sensitivity (MRS, dB) of the retina surrounding macular hole was 23.46 ± 3.01 dB at baseline, and significantly increased at 1 month (26.25 ± 2.31 dB, u = - 4.88, P < 0.01) and 4 months (27.14 ± 2.45 dB, t = - 6.29, P < 0.01). Patients with increased MRS are significantly younger than those with deceased MRS (59.72 ± 3.22 years vs. 65.60 ± 8.19 years, P < 0.01). After ILM peeling, the increasing extent of MRS was significantly higher in inferior and nasal retina than in superior and temporal retina at 1 and 4 months (P < 0.05).
ILM peeling in normal retina will not decrease the retinal function in a short-term after surgery.
通过微视野计 3（MP-3）评估内界膜（ILM）剥离围绕黄斑裂孔（MH）对视网膜功能的影响。
这是一项前瞻性队列研究，纳入了接受 23G 三通道经睫状体平坦部玻璃体切除术联合 ILM 剥除和空气填充治疗的 MH 患者。在手术前 1 周、术后 1 个月和 4 个月进行彩色眼底照相、视网膜光学相干断层扫描和 MP-3 检查。在 MP-3 检查中，使用了中央 8°视野内 45 个点的定制随访模式。选择对应于黄斑裂孔周围视网膜的点进行术前和术后功能比较。
纳入了 44 例患者的 44 只眼，最佳矫正视力（BCVA）为 1.06±0.40（logMAR）。所有眼在 4 个月时均获得解剖学成功。BCVA 在术后 1 个月（0.53±0.30，P<0.01）和 4 个月（0.31±0.24，P<0.01）显著提高。黄斑裂孔周围视网膜的平均视网膜敏感度（MRS，dB）在基线时为 23.46±3.01dB，术后 1 个月（26.25±2.31dB，u=-4.88，P<0.01）和 4 个月（27.14±2.45dB，t=-6.29，P<0.01）显著增加。MRS 增加的患者显著比 MRS 降低的患者年轻（59.72±3.22 岁 vs. 65.60±8.19 岁，P<0.01）。ILM 剥除后，术后 1 个月和 4 个月，下和鼻侧视网膜的 MRS 增加幅度显著高于上和颞侧视网膜（P<0.05）。
在短期内，正常视网膜的 ILM 剥除不会降低术后的视网膜功能。
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