特发性视网膜内囊样水肿型黄斑前膜的临床特征及预后。

CLINICAL FEATURES AND PROGNOSIS IN IDIOPATHIC EPIRETINAL MEMBRANES WITH DIFFERENT TYPES OF INTRARETINAL CYSTOID SPACES.

机构信息

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; and.

Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China.

出版信息

Retina. 2022 Oct 1;42(10):1874-1882. doi: 10.1097/IAE.0000000000003537.

DOI:10.1097/IAE.0000000000003537

PMID:36129264

Abstract

PURPOSE

To observe the characteristics and prognosis of different types of intraretinal cystoid spaces in idiopathic epiretinal membranes (iERMs).

METHODS

Two hundred and seven consecutive patients with symptomatic iERM who underwent vitrectomy between September 2016 and December 2019 were included. According to spectral-domain optical coherence tomography images, intraretinal cystoid spaces were classified into cystoid macular edema (CME) and microcystic macular edema (MME). Other optical coherence tomography characteristics, including ectopic inner foveal layers, central foveal thickness, and interdigitation zone integrity, were also evaluated.

RESULTS

Intraretinal cystoid spaces were presented in 30.1% of the iERMs, 21.5% were CME-type, 66.2% were MME-type, and 12.3% were combined-type. Compared with CME, eyes with MME-type and combined-type showed a significantly lower best-corrected visual acuity (BCVA) preoperatively and postoperatively. Cystoid macular edema is always presented in earlier stages (92.9%) and has no significant effects on BCVA (PStage I = 0.927, PStage II = 0.985). Conversely, MME is the primary type in advanced stages associated with a longer duration of symptoms (P = 0.037) and lower preoperative BCVA (P = 0.008). After surgery, cystoid spaces were newly occurred in 33 eyes (21.6%), with no effects on BCVA (P = 0.668). In the multiple regression analysis, the presence of MME was a risk factor for preoperative BCVA (P = 0.001). However, it is not an independent predictor for the postoperative VA.

CONCLUSION

Our research further proved that MME is an adverse factor for preoperative and postoperative VA in iERMs. Moreover, we underlined the importance of distinguishing between CME and MME, which may affect prognosis differently.

摘要

目的

观察特发性视网膜前膜（iERM）中不同类型的视网膜内囊样间隙的特征和预后。

方法

纳入 2016 年 9 月至 2019 年 12 月期间接受玻璃体切除术的 207 例有症状的 iERM 连续患者。根据谱域光相干断层扫描图像，将视网膜内囊样间隙分为囊样黄斑水肿（CME）和微囊样黄斑水肿（MME）。还评估了其他光学相干断层扫描特征，包括异位内黄斑层、中心黄斑厚度和交织区完整性。

结果

iERM 中存在视网膜内囊样间隙的占 30.1%，其中 CME 型占 21.5%，MME 型占 66.2%，混合型占 12.3%。与 CME 相比，MME 型和混合型术前和术后最佳矫正视力（BCVA）明显较低。CME 总是出现在较早的阶段（92.9%），对 BCVA 没有显著影响（PStage I = 0.927，PStage II = 0.985）。相反，MME 是晚期的主要类型，与症状持续时间较长有关（P = 0.037），且术前 BCVA 较低（P = 0.008）。术后 33 只眼（21.6%）新出现囊样间隙，对 BCVA 无影响（P = 0.668）。多元回归分析显示，存在 MME 是术前 BCVA 的危险因素（P = 0.001）。但它不是术后 VA 的独立预测因子。