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特发性视网膜前膜手术中黄斑区的地形学变化及其与视觉预后的关系

Topographic changes in macula and its association with visual outcomes in idiopathic epiretinal membrane surgery.

作者信息

Lee Seung Min, Park Sung Who, Byon Iksoo

机构信息

Department of Ophthalmology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.

Pusan National University School of Medicine, Yangsan, South Korea.

出版信息

PLoS One. 2025 Jan 9;20(1):e0316847. doi: 10.1371/journal.pone.0316847. eCollection 2025.

Abstract

PURPOSE

We investigated changes in macular topography and their association with visual acuity and metamorphopsia in the idiopathic epiretinal membrane (iERM).

METHODS

Twenty-four eyes that underwent vitrectomy and ERM removal with internal limiting membrane peeling were included in this study. Best-corrected visual acuity (BCVA) and horizontal/vertical metamorphopsia scores (h and vM-scores in the M-chart) were assessed. The distances of fovea-disc (FD) and fovea-vascular arcade (FV), central subfield macular thickness (CSMT), and foveal location were measured using fundus photography, optical coherence tomography (OCT), and OCT angiography, respectively.

RESULTS

The BCVA (logMAR) and vM-scores (P < 0.001, P = 0.014, respectively) improved after surgery. The distance of the FD decreased (P < 0.001) and FVs increased (P < 0.001, both). The fovea moved horizontally toward the disc (P < 0.001). The change in median total FVs (7.114 mm to 7.369 mm, P = 0.001) correlated with the change in BCVA (P = 0.049, Pearson's [r] = -0.404). No topographic parameters were associated with an improvement in the vM score.

CONCLUSIONS

The macular topography significantly changed after iERM removal; the fovea moved nasally, and the distance between the superior and inferior vascular arcades increased. Such a change was relevant to the improvement in BCVA, but not metamorphopsia.

摘要

目的

我们研究了特发性视网膜前膜(iERM)患者黄斑形态的变化及其与视力和视物变形的关系。

方法

本研究纳入了24只接受玻璃体切除术及视网膜前膜剥除联合内界膜剥除的眼睛。评估最佳矫正视力(BCVA)和水平/垂直视物变形评分(M图中的h和vM评分)。分别使用眼底照相、光学相干断层扫描(OCT)和OCT血管造影测量黄斑中心凹-视盘(FD)距离、黄斑中心凹-血管弓(FV)距离、黄斑中心子区域厚度(CSMT)以及黄斑中心凹位置。

结果

术后BCVA(logMAR)和vM评分(分别为P < 0.001,P = 0.014)均有所改善。FD距离减小(P < 0.001),FV距离均增加(P < 0.001)。黄斑中心凹水平向视盘移动(P < 0.001)。FV总距离中位数的变化(从7.114 mm至7.369 mm,P = 0.001)与BCVA的变化相关(P = 0.049,Pearson相关系数[r] = -0.404)。没有地形学参数与vM评分的改善相关。

结论

iERM剥除术后黄斑形态发生显著变化;黄斑中心凹向鼻侧移动,上下血管弓之间的距离增加。这种变化与BCVA的改善相关,但与视物变形无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f525/11717306/6d2aaf7d5201/pone.0316847.g001.jpg

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