Ophthalmology Department, Royal Brisbane and Women's Hospital, Level 8 Ned Hanlon Building, Brisbane, QLD, 4029, Australia.
Int Ophthalmol. 2022 Oct;42(10):3243-3252. doi: 10.1007/s10792-022-02317-2. Epub 2022 May 18.
To provide a current review of the evidence for the utility of preoperative ocular coherence tomography (OCT) parameters in prognosticating postoperative visual acuity and visual improvement after idiopathic epiretinal membrane surgery. To determine which OCT bio-markers are most useful in this regard and where future studies may apply more emphasis.
An extensive search of the PubMed database was performed for studies investigating this relationship. Key search terms included: idiopathic, epiretinal membrane, surgery, peel, vitrectomy, vision, outcomes, visual acuity, ocular coherence tomography, central foveal thickness, foveal contour, foveal morphology, ectopic inner foveal layers, inner retinal layers, inner retinal irregularity index, outer retinal layers, ellipsoid zone, interdigitation zone, photoreceptor outer segment length, central bouquet abnormality, staging, choroidoscleral irregularity, ganglion cell and nerve fibre layers, inner and outer plexiform layers, inner and outer nuclear layers. Forty-nine peer-reviewed articles were included in this review. These consisted of 28 retrospective studies [1-3,13,16-18,20,23-29,32-36,38,40,42-47], 17 prospective studies[6-12,14,19,21,22,30,31,37,41,48,49], 2 reviews [4,39] and 2 systematic reviews [5,15].
The weight of literary evidence seems to support photoreceptor integrity as the most consistent OCT marker of better postoperative visual acuity. This includes analysis of ellipsoid and interdigitation zones as well as photoreceptor outer segment length. However, the newer OCT staging system proposed by Govetto et al. (2017) fulfils a need for a clinically useful and evidence-based OCT classification. It may be the way forward in prognosticating ERM surgical outcomes by preoperative stratification. There is insufficient evidence to suggest the other discussed parameters in this review as useful prognosticators of postoperative visual acuity.
提供关于术前眼部相干断层扫描（OCT）参数在预测特发性视网膜前膜手术后术后视力和视觉改善的效用的最新证据综述。确定在这方面最有用的 OCT 生物标志物，以及未来研究可能更注重的方向。
对 PubMed 数据库进行了广泛的搜索，以研究这方面的关系。主要搜索词包括：特发性、视网膜前膜、手术、剥离、玻璃体切割术、视力、结果、视力、眼部相干断层扫描、中央凹视网膜厚度、视网膜形态、内视网膜不规则指数、外视网膜层、椭圆体带、内界膜、光感受器外节长度、中央花束异常、分期、脉络膜视网膜不规则、节细胞和神经纤维层、内丛状层和外丛状层、内核层。本综述纳入了 49 篇同行评审文章。其中包括 28 项回顾性研究[1-3,13,16-18,20,23-29,32-36,38,40,42-47]、17 项前瞻性研究[6-12,14,19,21,22,30,31,37,41,48,49]、2 篇综述[4,39]和 2 篇系统评价[5,15]。
文献证据似乎支持光感受器完整性作为更好术后视力的最一致的 OCT 标志物。这包括对椭圆体和内界膜带以及光感受器外节长度的分析。然而，Govetto 等人（2017 年）提出的新的 OCT 分期系统满足了临床有用和基于证据的 OCT 分类的需求。它可能是通过术前分层预测 ERM 手术结果的一种方法。没有足够的证据表明本综述中讨论的其他参数作为术后视力的有用预后指标。
