超声乳化玻璃体切割术后单侧特发性视网膜内界膜的脉络膜结构变化。

Choroidal structural changes following vitrectomy performed with phacoemulsification in unilateral idiopathic epiretinal membrane.

机构信息

Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.

Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, 639 Zhizaoju Road, Shanghai, 200011, China.

出版信息

BMC Ophthalmol. 2023 Feb 6;23(1):52. doi: 10.1186/s12886-023-02803-w.

DOI:10.1186/s12886-023-02803-w

PMID:36747177

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9901130/

Abstract

BACKGROUND

This study aims to determine the influence of vitrectomy combined with macular epiretinal membrane dissection and internal limiting membrane (ILM) peeling and phacoemulsification on choroidal vasculature in patients with unilateral idiopathic epiretinal membrane (IERM) and concurrent cataract using optical coherence tomography (OCT).

METHODS

This retrospective study included 26 eyes of 26 patients (8 males and 18 females) with unilateral IERM without vitreomacular traction (VMT) (group 1) and the patients' fellow eyes (n = 26, group 2). Three-port 25-G pars plana vitrectomy (PPV) combined with macular epiretinal membrane dissection and ILM peeling and phacoemulsification was performed on all patients. The comprehensive ophthalmologic examinations of all patients involved OCT measurements at every visit before and after surgery, and the choroidal thickness (CT), central macular thickness (CMT) and choroidal vascularity index (CVI) were calculated.

RESULTS

The mean age of the IERM patients was 66.58 ± 7.06 years. Postoperatively, best corrected visual acuity (BCVA) was significantly greater than baseline (P = 0.023). The CVI of the IERM eyes was significantly lower (P < 0.01) than that of the fellow eyes at baseline. The subfoveal CT in the IERM eyes was lower than that in the fellow eyes (P = 0.023), but there was, no significant difference in the average CT between the two groups at baseline (P = 0.071). In eyes with IERM, the CVI significantly increased at 1 week, 1 month (P < 0.001), and 3 months (P = 0.049) postoperatively, the subfoveal CT was markedly thickened 1 month after surgery (P = 0.001), the temporal 3 mm and nasal CT significantly increased at 1 week and 1 month postoperatively (P = 0.041, P = 0.022 for temporal 3 mm; P < 0.001, P = 0.047 for nasal 1.5 mm; P = 0.01, P = 0.001 for nasal 3 mm), and only the temporal 3 mm CT increased significantly at 3 months postoperatively (P = 0.017). The baseline CMT of the IERM eyes was significantly thicker than that of the fellow eyes (P < 0.001). CMT significantly decreased at 3 months postoperatively in IERM eyes(P = 0.033).

CONCLUSIONS

The increase in the CVI in the IERM eyes without VMT after combined PPV with ILM peeling and phacoemulsification persists for at least 3 months.

摘要

背景

本研究旨在通过光学相干断层扫描（OCT）评估 25G 三通道玻璃体切除术联合黄斑内界膜（ILM）剥除和白内障超声乳化术对单侧特发性黄斑前膜（IERM）合并白内障患者脉络膜血流的影响。

方法

本回顾性研究纳入了 26 例（8 名男性，18 名女性）单侧无玻璃体黄斑牵引（VMT）的 IERM 患者（组 1）和这些患者的对侧眼（n=26，组 2）。所有患者均接受了 25G 三通道经睫状体平坦部玻璃体切除术（PPV）联合黄斑内界膜剥除和白内障超声乳化术。所有患者的全面眼科检查均包括术前和术后每次就诊的 OCT 测量，计算脉络膜厚度（CT）、中心黄斑厚度（CMT）和脉络膜血管指数（CVI）。

结果

IERM 患者的平均年龄为 66.58±7.06 岁。术后最佳矫正视力（BCVA）明显高于基线（P=0.023）。基线时 IERM 眼的 CVI 明显低于对侧眼（P<0.01）。IERM 眼的中心凹下 CT 低于对侧眼（P=0.023），但两组基线平均 CT 无显著性差异（P=0.071）。在 IERM 眼中，术后 1 周、1 个月（P<0.001）和 3 个月（P=0.049）时 CVI 显著增加，术后 1 个月时中心凹下 CT 明显增厚（P=0.001），术后 1 周和 1 个月时颞侧 3mm 和鼻侧 CT 明显增加（P=0.041，P=0.022 为颞侧 3mm；P<0.001，P=0.047 为鼻侧 1.5mm；P=0.01，P=0.001 为鼻侧 3mm），仅在术后 3 个月时颞侧 3mm CT 明显增加（P=0.017）。IERM 眼的基线 CMT 明显大于对侧眼（P<0.001）。IERM 眼的 CMT 在术后 3 个月时明显下降（P=0.033）。