Fan Yuanyuan, Jiang Yingying, Mu Zhaoxia, Xu Yulian, Xie Ping, Liu Qinghuai, Pu Lijun, Hu Zizhong
Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
Department of Ophthalmology, Zhangjiagang Hospital Affiliated to Soochow University, Suzhou, Jiangsu 215600, China.
J Ophthalmol. 2025 May 7;2025:9299651. doi: 10.1155/joph/9299651. eCollection 2025.
In clinical practice, some eyes preoperatively diagnosed with "idiopathic epiretinal membranes (iERM)" will be amended to "secondary epiretinal membranes (sERM)" once peripheral retinal hole is detected. This study utilized optical coherence tomography (OCT) images to compare the characteristics between the iERM and sERM due to peripheral retinal hole (PRH). In this retrospective, cross-sectional study, 635 eyes that had undergone pars plana vitrectomy with membrane peeling were enrolled. A total of 115 eyes (18.1%) detected with peripheral retinal holes were allocated to the sERM-PRH group while the other 520 eyes were to the iERM group. The demographic data and OCT characteristics were compared between the two groups. Besides, all the eyes were evaluated by a double-grading scheme: severity grading of ERM progression into four stages plus anatomical classification into three kinds of part-thickness macular holes associated with ERMs. No significant difference was found in age, gender, symptom duration, axial length, or best-corrected visual acuity between the two groups. There was also no difference concerning the features based on OCT, ranging from central macular thickness, the ratios of the photoreceptor inner/outer segment junction line defect, intraretinal fluid, cotton ball sign, to epiretinal proliferation. However, the native difference in parafoveal thickness between the temporal and nasal quadrants was observed in the iERM group, yet disappeared in the sERM-PRH group. Moreover, eyes between the two groups were distributionally similar in both grading scales. Our results demonstrated that even OCT images could hardly provide effective clues for early differentiating sERM from iERM, which highlighted the necessity of a thorough pre- and intro-operative fundus examination of the peripheral retina for clinicians.
在临床实践中，一些术前被诊断为“特发性视网膜前膜（iERM）”的眼睛，一旦检测到周边视网膜裂孔，就会被修正为“继发性视网膜前膜（sERM）”。本研究利用光学相干断层扫描（OCT）图像比较了因周边视网膜裂孔（PRH）导致的iERM和sERM之间的特征。在这项回顾性横断面研究中，纳入了635例行玻璃体切割联合膜剥除术的眼睛。共有115只（18.1%）检测到周边视网膜裂孔的眼睛被分配到sERM-PRH组，而另外520只眼睛被分配到iERM组。比较了两组的人口统计学数据和OCT特征。此外，所有眼睛均采用双分级方案进行评估：ERM进展的严重程度分为四个阶段，加上与ERM相关的三种部分厚度黄斑裂孔的解剖学分类。两组在年龄、性别、症状持续时间、眼轴长度或最佳矫正视力方面均未发现显著差异。在基于OCT的特征方面也没有差异，从中心黄斑厚度、光感受器内/外节交界线缺陷率、视网膜内液、棉絮斑征到视网膜前增殖。然而，在iERM组中观察到颞侧和鼻侧象限之间黄斑旁厚度的固有差异，但在sERM-PRH组中消失。此外，两组眼睛在两种分级量表中的分布相似。我们的结果表明，即使是OCT图像也很难为早期区分sERM和iERM提供有效线索，这突出了临床医生在术前和术中对周边视网膜进行全面眼底检查必要性。
