视网膜前膜以牵拉力依赖的方式损害视网膜内层。
Epiretinal Membrane Impairs the Inner Retinal Layer in a Traction Force-Dependent Manner.
作者信息
Kanzaki Yuki, Matoba Ryo, Kimura Shuhei, Hosokawa Mio M, Shiode Yusuke, Doi Shinichiro, Morita Tetsuro, Kanzaki Sayumi, Takasu Ippei, Tanikawa Atsuhiro, Morizane Yuki
机构信息
Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama City, Okayama, Japan.
Takasu Eye Clinic, Okayama City, Okayama, Japan.
出版信息
Ophthalmol Sci. 2023 Apr 15;3(3):100312. doi: 10.1016/j.xops.2023.100312. eCollection 2023 Sep.
PURPOSE
To investigate the relationship between retinal traction force and impairment of the inner retinal layer in patients with epiretinal membrane (ERM).
DESIGN
Nonrandomized, retrospective consecutive case series.
PARTICIPANTS
Two hundred nine eyes of 201 patients with idiopathic ERM who underwent vitrectomy for idiopathic ERM were enrolled.
METHODS
Retinal folds caused by ERM were visualized using en face OCT, and the maximum depth of retinal folds within the parafovea (MDRF) was measured. Focal macular electroretinogram (ERG) was used to measure the amplitude and implicit time of each component for the ERM eyes and the normal fellow eyes. B-scan OCT images were used to measure the thicknesses of the inner nuclear layer (INL) and outer nuclear layer (ONL) + outer plexiform layer (OPL). Expression of α-smooth muscle actin (α-SMA) in surgically removed ERM specimens was quantified by reverse-transcription polymerase chain reaction.
MAIN OUTCOME MEASURES
We analyzed the relationship between MDRF and the relative amplitudes of focal macular ERG (affected eye/fellow eye), the relationships between MDRF and the mean INL thickness and ONL+OPL thickness, comparison of INL thickness and ONL+OPL thickness for each area when cases were classified according to MDRF localization in the ETDRS chart, and the relationship between MDRF and the relative expression of α-SMA in the ERM specimens.
RESULTS
The MDRF significantly correlated with the relative amplitudes (affected eye/fellow eye) of b-waves and oscillatory potentials (r = -0.657, = 0.015; r = -0.569, = 0.042, respectively) and the mean INL thickness and ONL+OPL thickness (r = 0.604, < 0.001; r = 0.210, = 0.007, respectively). However, only the INL thickness progression rate was significantly correlated with the MDRF progression rate (r = 0.770, < 0.001). On case stratification by localization of MDRF based on the ETDRS chart, in regions other than temporal regions, the INL thickness was significantly greater in regions with MDRF than in other regions. The MDRF significantly correlated with α-SMA expression in the ERM specimens (r = 0.555, = 0.009).
CONCLUSIONS
The findings suggest that ERM impairs the inner retinal layer in a traction force-dependent manner.
FINANCIAL DISCLOSURES
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
目的
研究视网膜前膜（ERM）患者视网膜牵引力与视网膜内层损害之间的关系。
设计
非随机、回顾性连续病例系列。
研究对象
201例因特发性ERM接受玻璃体切除术的特发性ERM患者的209只眼。
方法
使用表面光学相干断层扫描（OCT）观察ERM引起的视网膜皱褶，并测量黄斑中心凹旁视网膜皱褶的最大深度（MDRF）。使用局灶性黄斑视网膜电图（ERG）测量ERM患眼和对侧正常眼各成分的振幅和隐含时间。B型OCT图像用于测量内核层（INL）和外核层（ONL）+外丛状层（OPL）的厚度。通过逆转录聚合酶链反应定量手术切除的ERM标本中α-平滑肌肌动蛋白（α-SMA）的表达。
主要观察指标
分析MDRF与局灶性黄斑ERG相对振幅（患眼/对侧眼）之间的关系、MDRF与平均INL厚度和ONL+OPL厚度之间的关系、根据ETDRS图表中MDRF定位对病例进行分类时各区域INL厚度和ONL+OPL厚度的比较，以及MDRF与ERM标本中α-SMA相对表达之间的关系。
结果
MDRF与b波和振荡电位的相对振幅（患眼/对侧眼）显著相关（r = -0.657，P = 0.015；r = -0.569，P = 0.042）以及平均INL厚度和ONL+OPL厚度（r = 0.604，P < 0.001；r = 0.210，P = 0.007）。然而，只有INL厚度进展率与MDRF进展率显著相关（r = 0.770，P < 0.001）。根据ETDRS图表基于MDRF定位对病例进行分层时，在颞侧区域以外的区域，有MDRF的区域INL厚度显著大于其他区域。MDRF与ERM标本中α-SMA表达显著相关（r = 0.555，P = 0.009）。
结论
研究结果表明，ERM以牵引力依赖的方式损害视网膜内层。
财务披露
作者对本文讨论的任何材料均无所有权或商业利益。
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