Qi Biying, Yu Yanping, Yang Xiaohan, Zhang Ke, Wu Xijin, Wang Xinbo, Liu Wu
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; and.
Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.
Retina. 2023 Apr 1;43(4):567-573. doi: 10.1097/IAE.0000000000003747.
To investigate the clinical features and surgical outcomes of idiopathic macular holes with epiretinal proliferation (EP).
This retrospective study included 282 eyes of 269 consecutive patients who underwent vitrectomy for idiopathic macular holes. Clinical demographic data, baseline and postoperative retinal microstructure features on optical coherence tomography images, best-corrected visual acuity, and postoperative closure rate were compared between eyes with and without EP.
EP was identified in 38 of 282 eyes (13.5%). Eyes with EP had a significantly longer symptom duration ( P = 0.019), higher frequency of pseudophakic conditions ( P = 0.034), presence of epiretinal membrane ( P < 0.001), and a larger base diameter ( P = 0.014) than those without EP. In addition, compared with eyes without EP, those with EP had a higher percentage of U-type closure ( P = 0.047) and a thicker central fovea ( P = 0.012) at 1 month postoperatively and a significantly lower frequency of ellipsoid zone disruption ( P = 0.033) and outer foveolar lucency ( P = 0.021) and a thicker central fovea ( P = 0.004) at 10 months postoperatively.
The presence of EP represents a more chronic pathogenic process but has no negative effect on postoperative outcomes and can even facilitate anatomical recovery after surgery.
探讨伴有视网膜前增殖（EP）的特发性黄斑裂孔的临床特征及手术效果。
这项回顾性研究纳入了269例连续接受特发性黄斑裂孔玻璃体切除术患者的282只眼。比较了有和没有EP的眼之间的临床人口统计学数据、光学相干断层扫描图像上的基线和术后视网膜微观结构特征、最佳矫正视力及术后闭合率。
282只眼中有38只（13.5%）发现有EP。与没有EP的眼相比，有EP的眼症状持续时间显著更长（P = 0.019），人工晶状体眼的比例更高（P = 0.034），存在视网膜前膜（P < 0.001），且裂孔基底直径更大（P = 0.014）。此外，与没有EP的眼相比，有EP的眼术后1个月U型闭合的比例更高（P = 0.047），中央凹更厚（P = 0.012），术后10个月椭圆体带破坏（P = 0.033）和黄斑小凹外透亮区（P = 0.021）的发生率显著更低，中央凹更厚（P = 0.004）。
EP的存在代表了一个更慢性的致病过程，但对术后结果没有负面影响，甚至可以促进手术后的解剖学恢复。
