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巩膜扣带术治疗孔源性视网膜脱离后视网膜前膜形成的评估:基于频域光学相干断层扫描图像的研究。

Evaluation of epiretinal membrane formation after scleral buckling for treating rhegmatogenous retinal detachment: En face optical coherence tomography image-based study.

机构信息

Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho Kita-Ku, Okayama City, Okayama, 700-8558, Japan.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2024 Feb;262(2):469-476. doi: 10.1007/s00417-023-06285-w. Epub 2023 Oct 21.

Abstract

PURPOSE

To assess epiretinal membrane (ERM) formation, severity, and the associated risk factors after scleral buckling using en face optical coherence tomography (OCT) images.

METHODS

Medical records of 61 consecutive patients (66 eyes) with rhegmatogenous retinal detachment who underwent scleral buckling were retrospectively reviewed. Posterior vitreous detachment (PVD) was determined based on B-scan OCT images. En face OCT images were used to visualize the ERM and retinal folds. ERM formation was identified by comparing en face images pre- and post-surgery. The maximum depth of the retinal folds (MDRF) was measured using en face imaging to objectively assess traction strength.

RESULTS

ERM formation occurred in 15 (22.7%) eyes at the final visit; the foveal pit was preserved in all cases. Parafoveal retinal folds were present in 5 (7.6%) eyes, with a mean MDRF of 21.8 ± 12.6 µm. No significant difference was observed in best-corrected visual acuity (logarithm of the minimal angle of resolution) between the ERM formation (-0.019 ± 0.128) and non-ERM formation (-0.001 ± 0.213) groups at the final visit (P = 0.593; Mann-Whitney U test). Multivariate logistic regression analysis revealed that older age and the presence of PVD were significant risk factors for ERM formation (odds ratio 1.07, 95% confidence interval 1.01-1.14, P = 0.032; odds ratio 5.26, 95% confidence interval 1.06-26.10, P = 0.042; respectively).

CONCLUSION

ERM occurred in 22.7% of cases but was mild and did not affect visual acuity. Older age and the presence of PVD are risk factors for ERM formation.

摘要

目的

利用共焦光学相干断层扫描(OCT)图像评估巩膜扣带术后眼内细胞外膜(ERM)的形成、严重程度及其相关危险因素。

方法

回顾性分析 61 例(66 只眼)接受巩膜扣带术的孔源性视网膜脱离患者的病历资料。根据 B 型超声 OCT 图像确定后玻璃体脱离(PVD)。共焦 OCT 图像用于观察 ERM 和视网膜皱褶。通过比较术前和术后的共焦图像来识别 ERM 的形成。使用共焦成像测量视网膜皱褶最大深度(MDRF),以客观评估牵引力。

结果

最终随访时,15 只(22.7%)眼出现 ERM 形成,所有病例均保留中心凹。5 只(7.6%)眼存在旁中心凹视网膜皱褶,平均 MDRF 为 21.8±12.6μm。最终随访时,ERM 形成组(0.019±0.128)和非 ERM 形成组(0.001±0.213)的最佳矫正视力(最小分辨角对数)差异无统计学意义(P=0.593;Mann-Whitney U 检验)。多因素逻辑回归分析显示,年龄较大和存在 PVD 是 ERM 形成的显著危险因素(比值比 1.07,95%置信区间 1.01-1.14,P=0.032;比值比 5.26,95%置信区间 1.06-26.10,P=0.042)。

结论

22.7%的病例出现 ERM,但程度较轻,不影响视力。年龄较大和存在 PVD 是 ERM 形成的危险因素。

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