Department of Ophthalmology, Medical University of Graz, Graz, Austria; and.
Karl Landsteiner Institute for Retinal Research and Imaging Vienna, Vienna, Austria.
Retina. 2022 Oct 1;42(10):1867-1873. doi: 10.1097/IAE.0000000000003567.
To prospectively compare microvascular changes of internal limiting membrane (ILM) peeled and nonpeeled eyes in patients with idiopathic epiretinal membranes using optical coherence tomography angiography.
Forty-two patients with epiretinal membranes underwent vitrectomy with (n = 22) or without ILM peeling (n = 20). The mean superficial capillary plexus foveal avascular zone area change between preoperative and three-month postoperative readings served as the main outcome measure. Secondary outcome parameters included mean changes in superficial capillary plexus parafoveal vessel density, central foveal thickness, retinal volume, and best-corrected visual acuity.
Mean superficial capillary plexus foveal avascular zone area change (μm 2 ) was 59 ± 74 in the ILM nonpeeling group compared with -12 ± 86 in the ILM peeling group ( P = 0.007). Similarly, mean superficial capillary plexus parafoveal vessel density change (%) was higher in the ILM nonpeeling group (ILM nonpeeling 4 ± 4, ILM peeling -2 ± 6, P = 0.003). The mean retinal volume reduction was higher in the ILM peeling group, and this difference also reached statistical significance ( P = 0.036). There were no intergroup differences in mean central foveal thickness change and mean best-corrected visual acuity change ( P = 0.409 and P = 0.440, respectively). Epiretinal membrane/ILM separation was achieved in 23 of 51 patients.
The macular microvasculature demonstrated more remodeling in the ILM nonpeeling group after three months.
前瞻性比较特发性视网膜内界膜(ILM)剥除和未剥除眼的光学相干断层扫描血管造影(OCTA)下的微血管变化。
42 例特发性视网膜内界膜前膜患者接受玻璃体切除术,其中 22 例(ILM 剥除组)和 20 例(非 ILM 剥除组)行 ILM 剥除。主要观察指标为术前和术后 3 个月时黄斑中心凹无血管区面积的平均浅层毛细血管丛改变。次要观察指标包括浅层毛细血管丛旁中心血管密度、中心凹厚度、视网膜体积和最佳矫正视力的平均变化。
与 ILM 剥除组(-12±86μm 2 )相比,ILM 未剥除组的浅层毛细血管丛黄斑中心凹无血管区面积改变(μm 2 )平均值为 59±74(P=0.007)。同样,ILM 未剥除组浅层毛细血管丛旁中心血管密度改变的平均值更高(ILM 未剥除 4±4%,ILM 剥除-2±6%,P=0.003)。ILM 剥除组的平均视网膜体积减少更高,差异也具有统计学意义(P=0.036)。两组间平均中心凹厚度改变和平均最佳矫正视力改变的差异均无统计学意义(P=0.409 和 P=0.440)。在 51 例患者中,有 23 例患者实现了视网膜内界膜/ILM 分离。
三个月后,ILM 未剥除组的黄斑微血管重塑更为明显。