Departments of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea ; and.
Departments of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Retina. 2021 Sep 1;41(9):1839-1850. doi: 10.1097/IAE.0000000000003132.
To investigate whether the parafoveal capillary architecture predicts clinical course and visual outcomes after epiretinal membrane (ERM) surgery.
A total of 71 eyes of 71 patients treated with vitrectomy for idiopathic ERM were enrolled. The parafoveal capillary displacement and fractal geometries were compared according to the stage of ERM. Correlations between the parafoveal capillary displacement in the superficial capillary plexus, the fractal dimension and lacunarity in the deep capillary plexus (DCP), foveal thickness, and visual outcomes were evaluated.
Compared with eyes with mild ERM, eyes with severe ERM exhibited higher parafoveal capillary displacement in the superficial capillary plexus, lower fractal dimension and higher lacunarity in the DCP, and greater foveal thickness (P < 0.05). The parafoveal capillary displacement in the superficial capillary plexus and fractal dimension and lacunarity in the DCP improved significantly, particularly at 1 month postoperatively (P < 0.05) and reached a plateau thereafter. The preoperative fractal dimension in the DCP showed a significant correlation with the best-corrected visual acuity at all follow-up time points (P < 0.05).
The parafoveal fractal dimension in the DCP was significantly correlated with the visual acuity before and after ERM surgery. The parafoveal fractal dimension may serve as a predictive marker for visual outcomes after ERM surgery.
研究黄斑区毛细血管旁结构是否可预测特发性视网膜前膜（ERM）手术后的临床病程和视力结果。
共纳入 71 例 71 只眼接受玻璃体切除术治疗的特发性 ERM 患者。根据 ERM 分期比较黄斑区毛细血管旁浅层毛细血管丛的毛细血管移位和分形几何，并评估浅层毛细血管丛中黄斑区毛细血管旁移位、深层毛细血管丛（DCP）的分形维数和空洞度与 foveal 厚度和视力结果之间的相关性。
与轻度 ERM 眼相比，重度 ERM 眼的浅层毛细血管丛中黄斑区毛细血管旁移位更高，DCP 中的分形维数和空洞度更低，foveal 厚度更大（P < 0.05）。浅层毛细血管丛中黄斑区毛细血管旁移位和 DCP 中的分形维数和空洞度均显著改善，特别是在术后 1 个月（P < 0.05），此后达到平台期。术前 DCP 中的分形维数与所有随访时间点的最佳矫正视力均显著相关（P < 0.05）。
DCP 中的黄斑区分形维数与 ERM 手术前后的视力明显相关。黄斑区分形维数可能是 ERM 手术后视力结果的预测指标。
