Pertile Grazia, Iacovello Daniela, Maraone Giorgia, Bottega Elisa, Guerriero Massimo, Maggio Emilia
Department of Ophthalmology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy.
Clinical Research Unit, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy.
Front Med (Lausanne). 2023 Apr 17;10:1156410. doi: 10.3389/fmed.2023.1156410. eCollection 2023.
To investigate morpho-functional changes after surgical treatment for ERM foveoschisis or lamellar macular hole (LMH), and to evaluate whether the two entities are associated with different healing processes and long-term outcomes.
Retrospective interventional case series.
A total of 56 eyes, treated for lamellar macular defects and followed up for 24 months, were enrolled. The eyes were divided into two groups: 34 with ERM foveoschisis and 22 with LMH. Changes in the following features were evaluated and compared between the two groups: best-corrected visual acuity (BCVA), external limiting membrane (ELM) and ellipsoid zone (EZ) defects, central foveal thickness (CFT), and autofluorescence (FAF) diameter and area.
After surgery, progressive BCVA improvement was observed with no significant difference between the two groups (-value: 0.06). An increased number of eyes with intact outer-retinal layers was found both in the ERM foveoschisis and LMH groups. FAF diameter and area decreased significantly throughout the FU with no significant difference between the two groups (-value: 0.2).
In the present study, significant functional and microstructural improvements were observed after surgery for both ERM foveoschisis and LMH, demonstrating considerable repair potential in both types of lamellar defects. These findings question the true "degenerative" nature of LMH.
研究视网膜前膜性黄斑劈裂或板层黄斑裂孔(LMH)手术治疗后的形态功能变化,并评估这两种情况是否与不同的愈合过程和长期预后相关。
回顾性干预性病例系列研究。
纳入56只接受板层黄斑缺损治疗并随访24个月的眼睛。将这些眼睛分为两组:34只患有视网膜前膜性黄斑劈裂,22只患有LMH。评估并比较两组在以下特征方面的变化:最佳矫正视力(BCVA)、外界膜(ELM)和椭圆体带(EZ)缺损、中心凹黄斑厚度(CFT)以及自发荧光(FAF)直径和面积。
手术后,观察到两组的BCVA均有逐步改善,差异无统计学意义(P值:0.06)。在视网膜前膜性黄斑劈裂组和LMH组中,视网膜外层完整的眼睛数量均增加。在整个随访期间,FAF直径和面积均显著减小,两组间差异无统计学意义(P值:0.2)。
在本研究中,视网膜前膜性黄斑劈裂和LMH手术后均观察到显著的功能和微观结构改善,表明两种类型的板层缺损均具有相当大的修复潜力。这些发现对LMH真正的“退行性”本质提出了质疑。