IRCCS-Fondazione Bietti ONLUS, Roma, Italy.
DICAAR Faculty of Engineering, University of Cagliari, Cagliari, Italy.
Retina. 2024 Apr 1;44(4):610-617. doi: 10.1097/IAE.0000000000004001.
To measure the tangential retinal displacement and vision before and after macular pucker surgery and study if pars plana vitrectomy with epiretinal membrane peeling allows the reconstitution of previous anatomy or else it results in a different configuration.
Retrospective series of patients undergoing pars plana vitrectomy for epiretinal membrane, with >6-month follow-up before and after surgery, complete with best-corrected visual acuity, optical coherence tomography, M-Charts, and infrared retinography. Tangential retinal displacement between earliest visit (T E ), time of surgery (T 0 ), and latest available visit (T L ) of the examined retina, concentric circles at 0.5, 1.5, and 4.5 mm radii, and the central horizontal and vertical meridians were measured. Tangential displacement was calculated as the optical flow of consecutive infrared photographs.
The study comprised 32 patients: 15 men and 17 women. Average preoperative and postoperative follow-up were 23.4 ± 27.9 months and 19.2 ± 11.8 months, respectively. Best-corrected visual acuity reduced before surgery (0.69 ± 0.16 Snellen to 0.46 ± 0.17; P < 0.001) and increased after (0.866 ± 0.16 Snellen; P < 0.001). Horizontal and vertical metamorphopsia increased between before surgery but only horizontal metamorphopsia significantly reduced after. Average tangential displacement before surgery was 35.6 ± 29.9 µ m versus 56.6 ± 41.3 µ m after ( P = 0.023). Preoperative and postoperative displacement within the fovea was less than over the entire area ( P < 0.001).
Retinal tangential displacement between diagnosis and surgery (T E - T 0 ) is less than the displacement occurring after surgery (T 0 - T L ). Postoperative displacement does not represent the restoration of the anatomy existing before the disease ensued but rather the resulting equilibrium of newly deployed forces.
测量黄斑皱襞手术后的视网膜切向移位和视力，并研究平面部玻璃体切除术联合视网膜内界膜剥除术后是否能重建先前的解剖结构，或者是否会导致不同的形态。
回顾性系列研究了接受平面部玻璃体切除术治疗视网膜内界膜的患者，术前和术后随访时间均超过 6 个月，随访内容包括最佳矫正视力、光学相干断层扫描、M-Charts 和红外视网膜摄影。在受检视网膜的最早就诊（T E ）、手术时（T 0 ）和最近就诊（T L ）之间测量视网膜的切向视网膜移位，以 0.5、1.5 和 4.5mm 半径的同心环以及中央水平和垂直子午线为基准。切向位移通过连续红外照片的光流计算。
本研究共纳入 32 例患者：男 15 例，女 17 例。术前和术后平均随访时间分别为 23.4±27.9 个月和 19.2±11.8 个月。术前最佳矫正视力下降（从 0.69±0.16 视力表降至 0.46±0.17；P<0.001），术后提高（0.866±0.16 视力表；P<0.001）。术前和术后水平性和垂直性视变形均增加，但仅水平性视变形术后显著减少。术前平均切向移位为 35.6±29.9µm，术后为 56.6±41.3µm（P=0.023）。术前和术后在黄斑区的位移小于整个区域的位移（P<0.001）。
诊断和手术时（T E -T 0 ）的视网膜切向移位小于手术时（T 0 -T L ）的位移。术后的位移并不代表疾病发生前解剖结构的恢复，而是新部署的力的平衡结果。
