一项使用 OCT 血管造影术分析特发性黄斑视网膜前膜患者玻璃体切除术后黄斑微血管特征的研究。
A study analyzing macular microvasculature features after vitrectomy using OCT angiography in patients with idiopathic macular epiretinal membrane.
机构信息
Eye Hospital of Wenzhou medical university, Zhejiang, China.
Chicago College of Optometry, Midwestern University, Downers Grove, IL, USA.
出版信息
BMC Ophthalmol. 2020 Apr 22;20(1):165. doi: 10.1186/s12886-020-01429-6.
BACKGROUND
To evaluate postoperative changes in retinal capillary plexus and to assess contributing factors in postoperative visual improvement using optical coherence tomography angiography (OCT-A) in patients with idiopathic epiretinal membrane (iERM) post membrane removal.
METHODS
Patients scheduled for vitrectomy and membrane peel for iERM were enrolled. 35 subjects were included for this study. OCT-A was used to measure the FAZ related parameters and the superficial and deep capillary plexus layers using 3 mm × 3 mm scans. Measurements were taken before surgery and at every post-surgical follow-up. The unaffected fellow eyes were used as controls. Evaluated factors included: BCVA, vessel density (VD) and retinal thickness (RT) in five regions, FAZ area, FAZ perimeter (PERIM), acircularity index (AI) and foveal vessel density (FD).
RESULTS
Compared with the control group, the foveal vessel density (FVD) in superficial capillary plexus (SCP) was greater in the epi-retinal membrane group (P < 0.0001), whereas both groups had comparable parafoveal vessel density (PRVD) in SCP (p > 0.05). After surgery there was a reduction in the PRVD in SCP. The FVD in DCP increased and the PRVD in DCP decreased at baseline (p < 0.001). After surgery there was an increase in PRVD in DCP. By 6 months post-op, the PRVD had no statistically significant difference compared with the control group (p > 0.05). D-value of LogMAR BCVA was positively correlated with pre-op LogMAR BCVA (p < 0.0001), FVD in SCP (p < 0.001). It was negatively correlated with FAZ area (P < 0.001) and PERIM (P < 0.05).
CONCLUSIONS
Vitrectomy and membrane removal led to the decrease of VD in SCP and the increase of PRVD in DCP. Patients with a more severe iERM may receive greater visual improvement with surgery.
TRIAL REGISTRATION
Trial registration number (TRN) and date of registration. ChiCTR2000031289, retrospectively registered, 2020.03.26.
背景
通过光学相干断层扫描血管造影术（OCT-A）评估特发性视网膜内界膜（iERM）患者在膜切除术后视网膜毛细血管丛的术后变化，并评估术后视力改善的相关因素。
方法
纳入接受玻璃体切除术和膜剥除术治疗 iERM 的患者。本研究共纳入 35 例患者。使用 3mm×3mm 扫描对 OCT-A 进行测量，以获得 FAZ 相关参数以及浅层和深层毛细血管丛层的测量值。在术前和每次术后随访时进行测量。正常未受影响的对侧眼作为对照。评估的因素包括：最佳矫正视力（BCVA）、五个区域的血管密度（VD）和视网膜厚度（RT）、FAZ 面积、FAZ 周长（PERIM）、非圆度指数（AI）和中心凹血管密度（FD）。
结果
与对照组相比，浅层毛细血管丛（SCP）的中心凹血管密度（FVD）在视网膜前膜组中更高（P<0.0001），而两组在 SCP 的旁中心凹血管密度（PRVD）相似（p>0.05）。手术后，SCP 的 PRVD 减少。DCP 中的 FVD 增加，DCP 中的 PRVD 减少（p<0.001）。手术后，DCP 的 PRVD 增加。术后 6 个月，与对照组相比，PRVD 无统计学差异（p>0.05）。LogMAR BCVA 的 D 值与术前 LogMAR BCVA 呈正相关（p<0.0001），与 SCP 中的 FVD 呈正相关（p<0.001）。与 FAZ 面积（P<0.001）和 PERIM（P<0.05）呈负相关。
结论
玻璃体切除术和膜切除术后，SCP 中的 VD 减少，DCP 中的 PRVD 增加。患有更严重 iERM 的患者术后视力改善可能更大。
试验注册
试验注册号（TRN）和注册日期。ChiCTR2000031289，回顾性注册，2020.03.26。
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