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葡萄膜炎患者的视网膜前膜:当前管理现状的更新。

Epiretinal membranes in patients with uveitis: an update on the current state of management.

机构信息

Southampton Eye Unit, University Hospital Southampton, Tremona Road, Hampshire, Southampton, SO16 6YD, UK.

Faculty of Medicine, University of Southampton, Southampton, UK.

出版信息

Int Ophthalmol. 2024 Jun 28;44(1):291. doi: 10.1007/s10792-024-03199-2.

Abstract

PURPOSE

This review aims to summarize the current knowledge concerning the clinical features, diagnostic work-up, and therapeutic approach of uveitic epiretinal membranes (ERM).

METHODS

A thorough investigation of the literature was conducted using the PubMed database. Additionally, a complementary search was carried out on Google Scholar to ensure the inclusion of all relevant items in the collection.

RESULTS

ERM is an abnormal layer at the vitreoretinal interface, resulting from myofibroblastic cell proliferation along the inner surface of the central retina, causing visual impairment. Known by various names, ERM has diverse causes, including idiopathic or secondary factors, with ophthalmic imaging techniques like OCT improving detection. In uveitis, ERM occurrence is common, and surgical intervention involves pars plana vitrectomy with ERM peeling, although debates persist on optimal approaches.

CONCLUSIONS

Histopathological studies and OCT advancements improved ERM understanding, revealing a diverse group of diseases without a unified model. Consensus supports surgery for uveitic ERM in progressive cases, but variability requires careful consideration and effective inflammation management. OCT biomarkers, deep learning, and surgical advances may enhance outcomes, and medical interventions and robotics show promise for early ERM intervention.

摘要

目的

本文旨在总结有关葡萄膜炎性视网膜内表面膜(ERM)的临床特征、诊断方法和治疗方法的现有知识。

方法

使用 PubMed 数据库进行了全面的文献调查。此外,还在 Google Scholar 上进行了补充搜索,以确保收集到所有相关项目。

结果

ERM 是一种位于玻璃体视网膜界面的异常层,由中央视网膜内表面的肌成纤维细胞增殖引起,导致视力损害。ERM 有多种名称,其病因包括特发性或继发性因素,眼部成像技术如 OCT 提高了其检测率。在葡萄膜炎中,ERM 的发生很常见,手术干预包括通过玻璃体切除术联合 ERM 剥离,但对于最佳方法仍存在争议。

结论

组织病理学研究和 OCT 技术的进步提高了对 ERM 的认识,揭示了一组没有统一模型的多种疾病。对于进行性葡萄膜炎性 ERM,手术治疗已达成共识,但由于存在差异,需要仔细考虑并有效控制炎症。OCT 生物标志物、深度学习和手术技术的进步可能会改善预后,而医学干预和机器人技术则为早期 ERM 干预提供了希望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27d/11213727/8cb2e2857aef/10792_2024_3199_Fig1_HTML.jpg

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