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特发性视网膜内皮层膜的复发及其相关因素:一项光学相干断层扫描研究。

RECURRENCE OF IDIOPATHIC EPIRETINAL MEMBRANE AND ITS PREDISPOSING FACTORS: An Optical Coherence Tomography Study.

机构信息

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea; and.

Department of Ophthalmology, Hanyang University Hospital, Seoul, Korea.

出版信息

Retina. 2021 Mar 1;41(3):516-524. doi: 10.1097/IAE.0000000000002868.

DOI:10.1097/IAE.0000000000002868
PMID:32604339
Abstract

PURPOSE

To evaluate the incidence and clinical course of recurrent epiretinal membrane (ERM) after ERM surgery and to identify predisposing optical coherence tomography (OCT) findings for the recurrence.

METHODS

Postoperative ERM recurrence, defined as reappearance of the membrane after its removal or regrowth of the remnant membrane, was investigated in 301 eyes with idiopathic ERM followed up for more than 6 months after macular surgery by fundus photographs and spectral-domain OCT. The incidences of recurrent ERM and its associated clinical characteristics were assessed. Preceding OCT findings in the area subsequently showing recurrent ERM were evaluated at early postoperative periods.

RESULTS

Among the 301 eyes that underwent ERM peeling, 119 (39.5%) and 86 (28.6%) showed ERM recurrence on OCT images and biomicroscopic examination/fundus photographs, respectively, during the follow-up period (average: 18.1 months). Neighboring remnant membrane and hyperreflective dots on the retinal surface at 1 week after the surgery and postoperative inner retinal wrinkling persisting for ≥1 month were predisposing OCT findings for ERM recurrence, with an odds ratio of 6.48 (95% confidence interval, 3.51-12.0), 3.48 (95% confidence interval, 1.81-6.70), and 6.11 (95% confidence interval, 3.30-11.3), respectively (all P < 0.001).

CONCLUSION

Incidence of ERM recurrence varies depending on the definition used for the recurrence. Optical coherence tomography examination may be useful for the prediction and sensitive detection of recurrent ERM.

摘要

目的

评估特发性视网膜前膜(ERM)手术后复发 ERM 的发生率和临床过程,并确定复发的潜在光学相干断层扫描(OCT)表现。

方法

对 301 例特发性 ERM 患者进行研究,这些患者在黄斑手术后超过 6 个月,通过眼底照片和频域 OCT 随访。定义术后 ERM 复发为膜切除后再次出现膜或残余膜再生。评估复发 ERM 的发生率及其相关临床特征。评估在术后早期在随后出现复发 ERM 的区域中先前的 OCT 发现。

结果

在接受 ERM 剥离的 301 只眼中,119 只(39.5%)和 86 只(28.6%)在 OCT 图像和生物显微镜检查/眼底照片中分别显示出 ERM 复发,在随访期间(平均:18.1 个月)。术后 1 周视网膜表面邻近残余膜和高反射点以及持续≥1 个月的术后内层视网膜皱襞是 ERM 复发的潜在 OCT 表现,优势比分别为 6.48(95%置信区间,3.51-12.0)、3.48(95%置信区间,1.81-6.70)和 6.11(95%置信区间,3.30-11.3)(均 P <0.001)。

结论

ERM 复发的发生率取决于用于定义复发的标准。OCT 检查可能有助于预测和敏感检测复发性 ERM。

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