Großpötzl Manuel, Malle Eva Maria, Riedl Regina, Gran Jakob Daniel, Djavid Daniel, Posch-Pertl Laura, Glatz Wilfried Maximilian, Falb Thomas, Lindner Ewald, Wedrich Andreas, Ivastinovic Domagoj
Department of Ophthalmology, Medical University of Graz, Graz, Austria.
Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Austria.
Heliyon. 2024 Jul 23;10(15):e35096. doi: 10.1016/j.heliyon.2024.e35096. eCollection 2024 Aug 15.
To evaluate retinal thickness changes of individual retinal layers using spectral-domain optical coherence tomography (SD-OCT) after uneventful cataract surgery over a 3-months period.
Prospective cohort study.
41 patients who underwent uneventful cataract surgery were included. Retinal SD-OCT images of both eyes were acquired preoperatively, 1 day after surgery as well as 1 month and 3 months postoperatively. Changes of retinal layer thickness were estimated after semi-automated segmentation for the following individual layers in the central subfield (CS, 1 mm) and inner ring (IR, 1-3 mm) of the early treatment diabetic retinopathy study (ETDRS) grid: retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), RNFL-GCL-IPL complex, inner nuclear layer (INL), outer plexiform layer (OPL), INL-OPL complex, outer nuclear layer (ONL), inner retina layer (IRL) and the total retina (TR). Furthermore, a sub-analysis with exclusion of patients devoid CME and an analysis in regard of patient age, lens status of the fellow eye, best corrected visual acuity and duration of surgery was conducted.
This study found significant alterations in all analysed retinal layers except for the RNFL (p = 0.33) and the GCL (p = 0.06) in the central subfield and the INL-OPL complex (p = 0.07) in the inner ring over the 3-months period (all p < 0.05). Retinal thickness decreases on the first postoperative day, followed by a significant increase 1 month after surgery and subsequent reduction at 3 months following uneventful cataract surgery could be observed.
These results assume the hypothesis that the apex of inflammatory response, characterized by an augmentation in the thickness of individual retinal layers, occurs around 1 month after uneventful cataract surgery, and subsequently experience a reduction in activity. Therefore, we suggest that additional therapy for cystoid macular edema does not have to be initiated as early as the first month in mild cases.
使用光谱域光学相干断层扫描（SD-OCT）评估白内障手术顺利完成后3个月内各个视网膜层的视网膜厚度变化。
前瞻性队列研究。
纳入41例行白内障手术且过程顺利的患者。术前、术后1天以及术后1个月和3个月采集双眼的视网膜SD-OCT图像。在早期糖尿病视网膜病变研究（ETDRS）网格的中央子区域（CS，1mm）和内环（IR，1 - 3mm）中，对以下各个视网膜层进行半自动分割后估计视网膜层厚度的变化：视网膜神经纤维层（RNFL）、神经节细胞层（GCL）、内网状层（IPL）、RNFL - GCL - IPL复合体、内核层（INL）、外网状层（OPL）、INL - OPL复合体、外核层（ONL）、视网膜内层（IRL）和整个视网膜（TR）。此外，进行了一项排除无黄斑囊样水肿（CME）患者的亚分析，并针对患者年龄、对侧眼晶状体状态、最佳矫正视力和手术时长进行了分析。
本研究发现，在3个月期间，除中央子区域的RNFL（p = 0.33）和GCL（p = 0.06）以及内环的INL - OPL复合体（p = 0.07）外，所有分析的视网膜层均有显著变化（所有p < 0.05）。可以观察到，白内障手术顺利完成后，术后第1天视网膜厚度下降，随后在术后1个月显著增加，3个月时又随后下降。
这些结果支持这样的假设，即个体视网膜层厚度增加所表征的炎症反应高峰出现在白内障手术顺利完成后约1个月，随后炎症活动减弱。因此，我们建议在轻度病例中，不必早在第一个月就开始针对黄斑囊样水肿的额外治疗。
