Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Ophthalmology, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
J AAPOS. 2022 Aug;26(4):179.e1-179.e5. doi: 10.1016/j.jaapos.2022.05.002. Epub 2022 Jul 13.
To evaluate the prevalence of retinal misregistration, that is, misalignment of retinal elements that affect central and peripheral fusion, and the effect of surgery in patients with epiretinal membrane (ERM).
This prospective interventional case-series was performed on 32 patients with symptomatic ERM with the complaint of binocular diplopia or decreased visual acuity. After the diagnosis of ERM, optotype frame, synoptophore, and lights on-off tests were used to evaluate retinal misregistration. Patients with severe symptoms underwent surgery and were followed for 3 months.
Of the 32 patients, 6 (19%) had preoperative diplopia. Optotype frame, synoptophore, and lights on-off tests had positive results in 20 (63%), 19 (63%), and 11 (34%) cases, respectively. Of the 6 diplopia cases, 5 showed positive results in all 3 tests and 1 was positive on optotype frame and synoptophore testing. Of the 26 cases without diplopia, 15 (58%) showed positive results in at least one test, including 6 (23%) in all three tests, 6 (23%) in two tests, and 3 (12%) in only one test. Ten patients underwent surgery. Postoperatively, all patients had negative lights on-off test, but optotype frame and synoptophore tests were negative in eight patients (80%). Two cases (20%) had postoperative diplopia, including 1 case with postoperative new-onset diplopia.
The prevalence of retinal misregistration was higher than the rate of diplopia. Surgery improved diplopia and results of tests of retinal misregistration.
评估视网膜失配的发生率，即影响中心和周边融合的视网膜元素的错位，并评估内界膜（ERM）患者手术的效果。
对 32 例有症状的 ERM 患者进行前瞻性干预性病例系列研究，这些患者有双眼复视或视力下降的主诉。在诊断出 ERM 后，使用视力表、同视机和光开关试验来评估视网膜失配。有严重症状的患者进行手术，并随访 3 个月。
32 例患者中，术前有 6 例（19%）有复视。视力表、同视机和光开关试验的阳性结果分别为 20 例（63%）、19 例（63%）和 11 例（34%）。在 6 例复视病例中，5 例在所有 3 项检查中均为阳性，1 例在视力表和同视机检查中为阳性。在 26 例无复视病例中，15 例（58%）至少有一项检查结果阳性，包括 6 例（23%）在所有 3 项检查中，6 例（23%）在 2 项检查中，3 例（12%）仅在 1 项检查中。10 例患者接受了手术。术后所有患者光开关试验均为阴性，但 8 例患者（80%）视力表和同视机检查仍为阴性。2 例（20%）术后有复视，其中 1 例为术后新发复视。
视网膜失配的发生率高于复视发生率。手术改善了复视和视网膜失配检查的结果。
