Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
Takasu Eye Clinic, Okayama, Japan.
Ophthalmol Retina. 2021 Aug;5(8):815-823. doi: 10.1016/j.oret.2020.10.017. Epub 2020 Oct 28.
To analyze en face epiretinal membrane (ERM) images constructed using swept-source (SS) OCT and to determine the incidence of ERM formation after ERM surgery and its effects on visual function.
Retrospective, consecutive observational study.
Consecutive series of 73 eyes (71 patients) with idiopathic ERM that underwent vitrectomy with both ERM and internal limiting membrane (ILM) peeling.
We retrospectively reviewed the data of the 73 eyes included in the study. During surgery, the ERM was removed as extensively as possible, and the ILM was removed such that the area of ILM peeling was at least larger than the parafoveal area. All patients underwent comprehensive ophthalmologic examinations, including assessments of best-corrected visual acuity and metamorphopsia, before and at 2 weeks and 6 months after the surgery. En face images constructed using SS OCT were used to investigate ERM formation.
The incidence of ERM formation at 6 months after the surgery, effects of ERM formation on visual function, and the relationship between ERM formation and the extent of ERM and ILM peeling.
At 6 months after ERM and ILM peeling, 8 eyes (11.0%) showed ERM formation (formation group). Twenty eyes (27.4%) exhibited remnant ERM without ERM formation (remnant group), whereas 45 eyes (61.6%) showed no ERM (no ERM group). In both the remnant and no ERM groups, best-corrected visual acuity and metamorphopsia showed significant improvements after ERM surgery (both P < 0.01); these improvements were not seen in the formation group (P = 0.067 and P = 0.053, respectively). However, no significant differences were found in preoperative and postoperative best-corrected visual acuities and metamorphopsia among the 3 groups. In the formation group, ERM formation occurred only in the area with residual ILM. Most patients who underwent ILM peeling in which the area of the peeling covered the ERM belonged to the no ERM group (97.7%; P < 0.01).
Epiretinal membrane formation does not affect visual function significantly when the area of ILM peeling is larger than the parafoveal area. When the ILM peeling area covers the ERM area, postoperative ERM formation can be prevented.
分析应用扫频源（SS）OCT 构建的视网膜内表面膜（ERM）图像，并确定 ERM 手术后 ERM 形成的发生率及其对视功能的影响。
回顾性、连续观察性研究。
连续系列的 73 只眼（71 例）患有特发性 ERM，这些眼均接受了玻璃体切除术，同时进行 ERM 和内界膜（ILM）剥除。
我们回顾性分析了纳入研究的 73 只眼的数据。手术中尽可能广泛地切除 ERM，并切除 ILM，使 ILM 剥除面积至少大于中心凹旁区。所有患者均在手术前及术后 2 周和 6 个月进行全面眼科检查，包括最佳矫正视力和变形觉评估。应用 SS-OCT 构建的视网膜内表面图像用于研究 ERM 形成。
术后 6 个月 ERM 形成的发生率、ERM 形成对视功能的影响，以及 ERM 形成与 ERM 和 ILM 剥除程度的关系。
ERM 和 ILM 剥除术后 6 个月，8 只眼（11.0%）出现 ERM 形成（形成组）。20 只眼（27.4%）表现为无 ERM 形成的残余 ERM（残余组），而 45 只眼（61.6%）无 ERM（无 ERM 组）。在残余组和无 ERM 组中，ERM 手术后最佳矫正视力和变形觉均显著改善（均 P < 0.01）；而在形成组中未观察到这些改善（分别为 P = 0.067 和 P = 0.053）。然而，3 组间术前和术后最佳矫正视力和变形觉无显著差异。在形成组中，ERM 形成仅发生在残余 ILM 区域。在 ILM 剥除面积覆盖 ERM 区域的患者中，大多数属于无 ERM 组（97.7%；P < 0.01）。
当 ILM 剥除面积大于中心凹旁区时，ERM 形成不会显著影响视功能。当 ILM 剥除区域覆盖 ERM 区域时，可以预防术后 ERM 形成。
