Zou Jing, Tan Wei, Huang Wenlong, Liu Kangcheng, Li Fangling, Xu Huizhuo
Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
Hunan Key Laboratory of Ophthalmology, Changsha, Hunan Province, China.
PeerJ. 2020 Jul 10;8:e9481. doi: 10.7717/peerj.9481. eCollection 2020.
We investigated the correlation between visual acuity (VA) and individual retinal layer thickness in the foveal, parafoveal, and perifoveal regions of patients with an idiopathic epiretinal membrane (ERM).
One hundred and five subjects presenting with unilateral idiopathic ERM were included in this study. We segmented each patient's optical coherence tomography (OCT) image into seven layers and calculated the mean layer thickness in the foveal, parafoveal, and perifoveal regions using the Iowa Reference Algorithm. In 105 patients with ERM, we detected correlations between their macular regions' individual retinal layer thickness and their best corrected VA. Thirty-one of the 105 patients with ERM underwent vitrectomy and completed six months of follow-up. We then compared the 31 surgical patients' preoperative and postoperative individual retinal layer thickness in each macular region. Additionally, the association between preoperative individual retinal layer thickness in each macular region and VA six months post-surgery in patients with ≥ two Snellen lines of visual improvement was determined.
Multiple linear regression analysis showed that the inner nuclear layer (INL) thickness in the foveal, parafoveal, and perifoveal region were all associated with VA in the 105 patients ( = 0.344, < 0.001; = 0.427, < 0.001; and = 0.340, < 0.001, respectively). Thirty-one surgical patients 6 months post-surgery showed significantly decreased thicknesses ( ≤ 0.012) of the foveal INL, inner plexiform layer (IPL), and outer nuclear layer (ONL); the parafoveal retina nerve fiber layer (RNFL), IPL, INL, and ONL; and the perifoveal RNFL, IPL, INL, ganglion cell layer (GCL), outer plexiform layer (OPL), and photoreceptor layer (PRL). We found a weak correlation between postoperative VA and preoperative foveal and perifoveal RNFL thickness ( = 0.404 and = 0.359, respectively), and a moderate correlation between postoperative VA and preoperative foveal and parafoveal INL thickness ( = 0.529 and = 0.583, respectively) in the 31 surgical patients ( ≤ 0.047). The preoperative INL thickness in the foveal, parafoveal, and perifoveal regions showed a moderate to strong correlation ( = 0.507, 0.644, and 0.548, respectively), with postoperative VA in patients with ≥ 2 lines of visual improvement ( ≤ 0.038).
We detected a correlation between retinal damage and VA in the parafoveal, perifoveal, and foveal regions. Our results suggest that INL thickness in all macular regions may be a prognostic factor for postoperative VA in ERM patients.
我们研究了特发性视网膜前膜（ERM）患者的中心凹、旁中心凹和周边中心凹区域的视力（VA）与各视网膜层厚度之间的相关性。
本研究纳入了105例单侧特发性ERM患者。我们将每位患者的光学相干断层扫描（OCT）图像分割为七层，并使用爱荷华参考算法计算中心凹、旁中心凹和周边中心凹区域的平均层厚度。在105例ERM患者中，我们检测了其黄斑区各视网膜层厚度与最佳矫正视力之间的相关性。105例ERM患者中的31例接受了玻璃体切除术并完成了6个月的随访。然后我们比较了这31例手术患者每个黄斑区域术前和术后的各视网膜层厚度。此外，还确定了视力改善≥两行的患者术前每个黄斑区域的视网膜层厚度与术后6个月视力之间的关联。
多元线性回归分析显示，在这105例患者中，中心凹、旁中心凹和周边中心凹区域的内核层（INL）厚度均与视力相关（分别为β = 0.344，P < 0.001；β = 0.427，P < 0.001；β = 0.340，P < 0.001）。31例手术患者术后6个月显示，中心凹INL、内网状层（IPL）和外核层（ONL）厚度显著降低（P≤0.012）；旁中心凹视网膜神经纤维层（RNFL）、IPL、INL和ONL；周边中心凹RNFL、IPL、INL、神经节细胞层（GCL）、外网状层（OPL）和光感受器层（PRL）。我们发现，在这31例手术患者中（P≤0.047），术后视力与术前中心凹和周边中心凹RNFL厚度之间存在弱相关性（分别为r = 0.404和r = 0.359），术后视力与术前中心凹和旁中心凹INL厚度之间存在中度相关性（分别为r = 0.529和r = 0.583）。在视力改善≥两行的患者中，术前中心凹、旁中心凹和周边中心凹区域的INL厚度与术后视力之间存在中度至强相关性（分别为r = 0.507、0.644和0.548）（P≤0.038）。
我们检测到旁中心凹、周边中心凹和中心凹区域的视网膜损伤与视力之间存在相关性。我们的结果表明，所有黄斑区域的INL厚度可能是ERM患者术后视力的一个预后因素。
