Ophthalmic Clinic "Jasne Blonia", Lodz, Poland.
Ophthalmic Clinic "Jasne Blonia", Lodz, Poland.
Can J Ophthalmol. 2023 Dec;58(6):582-591. doi: 10.1016/j.jcjo.2022.06.023. Epub 2022 Jul 26.
To describe retinal morphology in idiopathic epiretinal membranes (ERMs) and to evaluate factors influencing function at different postoperative times up to 24 months.
Retrospective study.
A total of 121 eyes of 117 patients followed with spectral-domain optical coherence tomography for 24 months.
The following details were analyzed: type of ERM, central retinal thickness, and status of all retina layers in the fovea, especially the outer nuclear layer (ONL) and photoreceptor layer. We evaluated the presence of disorganization of retinal inner layers (DRIL), ectopic inner foveal layer (EIFL), elevation (stretching) of the ONL, cotton ball sign, and type connection between the retina and ERMs (complete adherence or multiple junction spots).
The percentage of DRIL, EIFL, and stretched ONL decreased. Several factors negatively influenced visual acuity during the early postoperative controls: age, interdigitation zone defects; presence of cotton ball sign, DRIL, EIFL, and stretched ONL; and strong adhesion of the ERMs to the retina. Twenty-four months after surgery, only DRIL and strong adhesion between ERMs and the retina remained statistically significant.
Younger patients (p < 0.001) and patients without DRIL (p < 0.001) experienced a faster recovery of function. The length of follow-up was associated with a decrease of factors influencing the final outcome. After 24 months, only the presence of DRIL and strong adhesion between the ERMs and the retina were significant. Assuming that DRIL appears in more advanced stages when compared with EIFL, this allows us to suggest that earlier surgery might be of more benefit in idiopathic ERMs.
描述特发性视网膜前膜（ERM）的视网膜形态，并评估不同术后时间影响功能的因素，最长随访时间达 24 个月。
回顾性研究。
共纳入 117 例患者的 121 只眼，这些患者接受了长达 24 个月的频域光学相干断层扫描（OCT）随访。
分析的细节包括：ERM 的类型、中心视网膜厚度以及黄斑区所有视网膜层的状态，特别是外核层（ONL）和光感受器层。我们评估了视网膜内层紊乱（DRIL）、内黄斑异位层（EIFL）、ONL 抬高（拉伸）、棉球状征以及视网膜与 ERM 之间的连接类型（完全粘连或多个连接点）的存在。
DRIL、EIFL 和拉伸的 ONL 的比例降低。一些因素在术后早期的视力评估中存在负面影响：年龄、内插间隙缺陷；存在棉球状征、DRIL、EIFL 和拉伸的 ONL；ERM 与视网膜的强粘连。术后 24 个月，只有 DRIL 和 ERM 与视网膜之间的强粘连在统计学上仍有显著意义。
年轻患者（p < 0.001）和无 DRIL 患者（p < 0.001）的功能恢复更快。随访时间与影响最终结果的因素减少有关。24 个月后，只有 DRIL 和 ERM 与视网膜之间的强粘连具有统计学意义。假设 DRIL 比 EIFL 出现得更晚，这使我们能够提出在特发性 ERM 中早期手术可能更有益。
