Department of Ophthalmology, Suining Central Hospital, Suining, P.R. China.
Department of Cardiovascular Medicine, Suining Third People's Hospital, Suining, P.R. China.
Curr Eye Res. 2023 Jun;48(6):584-590. doi: 10.1080/02713683.2023.2175367. Epub 2023 Feb 2.
To study the effect of intraoperative internal limiting membrane (ILM) peeling on the macular vascular structure in patients with diabetic epiretinal membrane (ERM).
Patients with diabetic ERM were divided into an ERM + ILM peeling group (18 eyes) and an ERM peeling group (19 eyes), all of whom underwent standard vitrectomy and were followed up until 6 months postoperatively. Best-corrected visual acuity (BCVA), Central macular thickness (CMT), Vessel density (VD) and vessel length density (VLD) of the superficial as well as deep retinal capillary plexus were compared between the two groups.
There was no significant difference in BCVA ( = .188, .410, .901, .916) and CMT ( = .164, .128, .110, .105) between the two groups at the week 1, month 1, month 3 and month 6 after operation. In the superficial capillary plexus (SCP), the change in VD ( = .106) and VLD ( = .438) was not affected by ILM peeling, and there was no significant difference in VD ( = .154, .063, .100, .162) and VLD ( = .386, .263, .431, .391) between the two groups during the four follow-up after operation. For the deep capillary plexus (DCP), there was an effect of ILM peeling on the changes in VD ( = .024) and VLD ( = .012), ILM peeling delayed the recovery time of the VD and VLD; The VD ( = .026, .000, .003) and VLD ( = .005, .000, .000) of ERM + ILM peeling group were lower than those of ERM peeling group from the month 1 to the month 6 after operation.
Intraoperative peeling of the ILM in patients with diabetic ERM delayed the improvement of blood flow signal in the DCP but did not affect the recovery of postoperative BCVA and CMT.
研究术中内界膜（ILM）剥除对糖尿病性视网膜内界膜（ERM）患者黄斑血管结构的影响。
将糖尿病性 ERM 患者分为 ERM+ILM 剥除组（18 眼）和 ERM 剥除组（19 眼），所有患者均接受标准玻璃体切除术，并在术后 6 个月进行随访。比较两组患者最佳矫正视力（BCVA）、中心黄斑厚度（CMT）、浅层和深层视网膜毛细血管丛的血管密度（VD）和血管长度密度（VLD）。
术后 1 周、1 个月、3 个月和 6 个月，两组间 BCVA（=.188，.410，.901，.916）和 CMT（=.164，.128，.110，.105）差异均无统计学意义。在浅层毛细血管丛（SCP）中，ILM 剥除对 VD（=.106）和 VLD（=.438）的变化没有影响，术后 4 次随访中，两组间 VD（=.154，.063，.100，.162）和 VLD（=.386，.263，.431，.391）差异均无统计学意义。对于深层毛细血管丛（DCP），ILM 剥除对 VD（=.024）和 VLD（=.012）的变化有影响，ILM 剥除延迟了 VD 和 VLD 的恢复时间；ERM+ILM 剥除组的 VD（=.026，.000，.003）和 VLD（=.005，.000，.000）从术后 1 个月至 6 个月均低于 ERM 剥除组。
糖尿病性 ERM 患者术中剥除 ILM 可延迟 DCP 血流信号的改善，但不影响术后 BCVA 和 CMT 的恢复。
