Chiang Mai University Faculty of Medicine, Department of Ophthalmology, Chiang Mai, Thailand
Erasmus Medical Center, Department of Ophthalmology, Rotterdam, The Netherlands
Turk J Ophthalmol. 2022 Apr 28;52(2):109-118. doi: 10.4274/tjo.galenos.2021.09258.
To evaluate the associations between anatomical changes and visual outcomes in patients with idiopathic epiretinal membrane (ERM).
We performed a prospective study of 130 consecutive idiopathic ERM patients and report their visual outcomes and the factors associated with visual outcome and anatomical changes.
Of 130 eyes of 130 patients, 87 eyes underwent surgery, while the remaining 43 eyes were observed. At 6-month follow-up, the best-corrected visual acuity (BCVA) increased in the whole population. Mean Early Treatment Diabetic Retinopathy Study letter score changed from 51 to 65 in the surgical group and from 67 to 68 in the non-surgical group. The surgical group had improvement in BCVA at all ERM stages and grades of disorganization of the retinal inner layers (DRIL) (p<0.01). In multivariable analysis of the surgical group, factors associated with BCVA of ETDRS 60 letters or more were no or mild DRIL and the absence of ellipsoid zone disruption at baseline (p=0.002 and p=0.034, respectively) and this statistically significant positive correlation was still maintained at 12-month follow-up.
Baseline DRIL grade and presence of ellipsoid zone disruption were the most informative prognostic factors in patients with idiopathic ERMs. Patients with severe DRIL and/or advanced ERMs had improved vision after ERM removal.
评估特发性视网膜内表面膜(ERM)患者解剖结构变化与视力结果之间的相关性。
我们对 130 例连续的特发性 ERM 患者进行了前瞻性研究,报告了他们的视力结果以及与视力结果和解剖结构变化相关的因素。
在 130 例患者的 130 只眼中,87 只眼接受了手术治疗,其余 43 只眼进行了观察。在 6 个月的随访中,整体人群的最佳矫正视力(BCVA)增加。手术组的早期治疗糖尿病视网膜病变研究字母评分从 51 提高到 65,非手术组从 67 提高到 68。手术组在所有 ERM 分期和视网膜内层(DRIL)组织紊乱程度的分级中均改善了 BCVA(p<0.01)。在手术组的多变量分析中,与 ETDRS 60 个字母或以上 BCVA 相关的因素是无或轻度 DRIL 以及基线时无椭圆体带破坏(p=0.002 和 p=0.034),在 12 个月的随访中,这种统计学上显著的正相关仍然存在。
基线 DRIL 分级和椭圆体带破坏的存在是特发性 ERM 患者最具信息性的预后因素。DRIL 严重和/或 ERM 进展的患者在去除 ERM 后视力得到改善。