Petersen Sekita Dalsgård, Christensen Ulrik Correll, Larsen Michael
Faculty of Health and Medicine, University of Copenhagen, 2200 Copenhagen, Denmark.
Department of Ophthalmology, Rigshospitalet, 2600 Glostrup, Denmark.
J Clin Med. 2024 Sep 26;13(19):5731. doi: 10.3390/jcm13195731.
The clinical use of optical coherence tomography (OCT) has revealed nerve fiber layer clefts in the retinal nerve fibers in eyes with macula-centered epiretinal membranes (ERMs). The purpose of this study is to describe the location and the extent of retinal nerve fiber layer (RNFL) clefts in eyes with symptomatic ERMs. We conducted a retrospective review of 17 individual eyes in 17 patients with symptomatic ERMs and a control group of 10 healthy eyes from 10 subjects who had been examined for unrelated causes. The examinations performed included best-corrected visual acuity, rebound tonometry, fundus photography, structural OCT and angiographic OCT (OCTA) made in the form of 12 × 12 mm angiographic volume scans. Hyporeflective RNFL clefts, seen in 14 out of 17 eyes with ERMs, were sharply demarcated in the presentation of slabs extending from the internal limiting membrane through the RNFL or including only the latter. The clefts were capillary-free on OCTA scans and formed depressions of the retinal surface. Most of the clefts were adjacent to and followed the course of the retinal trunk vessels, but clefts were also seen along smaller macular vessels and beyond the retinal vascular arcades. : Paravascular RNFL clefts can be observed beyond the vascular arcades and adjacent to small vessels on OCTA block scan data. This suggests that the direction and magnitude of tractional displacement of the inner retina in eyes with epimacular membranes can extend beyond the vascular arcades and add to an improved analysis of abnormal fundus findings.
光学相干断层扫描（OCT）的临床应用已揭示，在以黄斑为中心的视网膜前膜（ERM）的眼中，视网膜神经纤维层存在裂隙。本研究的目的是描述有症状ERM患者眼中视网膜神经纤维层（RNFL）裂隙的位置和范围。我们对17例有症状ERM患者的17只眼睛进行了回顾性研究，并以10名因无关原因接受检查的受试者的10只健康眼睛作为对照组。所进行的检查包括最佳矫正视力、眼压回弹测量、眼底照相、结构OCT以及以12×12毫米血管造影容积扫描形式进行的血管造影OCT（OCTA）。在17只患有ERM的眼睛中，有14只观察到低反射性RNFL裂隙，这些裂隙在从内界膜延伸穿过RNFL或仅包括RNFL的层面呈现中界限清晰。这些裂隙在OCTA扫描上无毛细血管，并形成视网膜表面的凹陷。大多数裂隙与视网膜主干血管相邻并沿其走行，但在较小的黄斑血管及视网膜血管弓之外也可见到裂隙。：在OCTA块扫描数据上，可在血管弓之外及小血管相邻处观察到血管旁RNFL裂隙。这表明，黄斑前膜患者眼内视网膜内层牵引移位的方向和程度可延伸至血管弓之外，有助于改进对异常眼底表现的分析。
