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不同类型黄斑裂孔视网膜前膜劈裂患者行巩膜外环扎下玻璃体切除术后的中心凹微结构与视力结局

Foveal Microstructure and Visual Outcomes after Pars Plana Vitrectomy in Patients with Different Types of Epiretinal Membrane Foveoschisis.

机构信息

Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China.

Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.

出版信息

Ophthalmic Res. 2024;67(1):137-144. doi: 10.1159/000536206. Epub 2024 Jan 20.

Abstract

INTRODUCTION

The aim of this study was to evaluate the clinical characteristics and surgical outcomes of the epiretinal membrane foveoschisis (ERM-FS) with different morphological types.

METHODS

This retrospective observational study reviewed 44 consecutive ERM-FS patients who underwent ERM surgery. According to the optical coherence tomography images, ERM-FS was classified into three groups: group A, FS crossed the fovea with the foveola elevated; group B, FS located at the foveal edges with a near-normal central foveal point thickness; and group C, FS with undermined foveal edges with a near-normal central foveal point thickness.

RESULTS

There were 10 eyes in group A, 20 eyes in group B, and 14 eyes in group C. Preoperatively, eyes in group A had the best best-corrected visual acuity (BCVA), the thickest central foveal point thickness, and the highest ellipsoid zone (EZ) intact rate among the three groups. After surgery, a resolution of foveoschisis was observed in 40.0%, 45.0%, and 50.0% of the eyes in group A, group B, and group C (p = 0.928), respectively. BCVA was significantly improved postoperatively. Although there was no significant difference in BCVA among the three groups at 1 month postoperatively, BCVA of group A was the best at 4 and 10 months. Correlation analysis indicated that the type of ERM-FS, baseline BCVA, central foveal point thickness, and postoperative EZ continuity (all p < 0.05) were important factors for the final BCVA.

CONCLUSIONS

The damage to the retinal structure and visual function was milder in group A ERM-FS. Our study emphasized the necessity of OCT-based subtyping in patients with ERM-FS.

摘要

简介

本研究旨在评估不同形态类型的视网膜内界膜裂孔伴黄斑劈裂(ERM-FS)的临床特征和手术结果。

方法

本回顾性观察研究纳入了 44 例接受 ERM 手术的 ERM-FS 连续患者。根据光学相干断层扫描图像,将 ERM-FS 分为三组:A 组,FS 穿过黄斑中心凹并伴有中心凹小凹抬高;B 组,FS 位于黄斑边缘,中央黄斑点厚度接近正常;C 组,FS 伴有黄斑边缘下凹,中央黄斑点厚度接近正常。

结果

A 组 10 眼,B 组 20 眼,C 组 14 眼。术前,A 组的最佳矫正视力(BCVA)、中央黄斑点厚度最厚、椭圆体带(EZ)完整率最高。术后,A、B、C 组分别有 40.0%、45.0%和 50.0%的眼 FS 完全分离(p = 0.928)。术后 BCVA 均明显提高。虽然术后 1 个月 3 组间 BCVA 无统计学差异,但 A 组术后 4 个月和 10 个月 BCVA 最好。相关性分析表明,ERM-FS 类型、基线 BCVA、中央黄斑点厚度和术后 EZ 连续性(均 p < 0.05)是最终 BCVA 的重要因素。

结论

A 组 ERM-FS 对视网膜结构和视功能的损伤较轻。本研究强调了 OCT 分型在 ERM-FS 患者中的必要性。

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