伴有内界膜撕裂的视网膜前膜的正面光学相干断层扫描成像

En Face OCT Imaging of Epiretinal Membranes Complicated by Internal Limiting Membrane Tears.

作者信息

Feo Alessandro, Santina Ahmad, Abraham Néda, Mafi Mostafa, Popovic Marko M, Govetto Andrea, Romano Mario R, Johnson Mark W, Sarraf David

机构信息

Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California of Los Angeles, David Geffen School of Medicine at UCLA, Los Angeles, California; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy.

Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California of Los Angeles, David Geffen School of Medicine at UCLA, Los Angeles, California.

出版信息

Ophthalmol Retina. 2025 Jun 2. doi: 10.1016/j.oret.2025.05.031.

DOI:10.1016/j.oret.2025.05.031

PMID:40466769

Abstract

PURPOSE

To describe the demographic, clinical, and en face OCT features of eyes with epiretinal membrane (ERM) with or without internal limiting membrane (ILM) tears.

DESIGN

Retrospective case series.

SUBJECTS

This single-institution study included 101 eyes of 101 patients with ERM.

METHODS

This single-institution study included 101 eyes of 101 patients with ERM.

MAIN OUTCOME MEASURES

Demographic and clinical data were collected from the electronic medical record. En face OCT of the ERM was reviewed and studied in every case and the prevalence of ILM tears was determined. Various en face OCT biomarkers associated with ILM tears were also evaluated including nerve fiber layer defects (NFLDs), which were classified as NFLD round (R), i.e., paravascular inner retinal defects (PIRDs), vs. NFLD oval (O) (i.e., inner retinal dimples [IRDs]). Schisis of the retinal nerve fiber layer (SNFL) and posterior vitreous detachment (PVD) grade were also assessed.

RESULTS

Internal limiting membrane tears were identified in 21 of 101 eyes (20.8%) with ERM. No significant differences in demographic or clinical characteristics were observed between ERM eyes with or without ILM tears. However, NFLDs (R) (i.e., PIRDs) were significantly (P < 0.05) more common (80.9% vs. 37.5%) in the ILM tear group vs. the non-ILM tear group. This was also the case for SNFL (57.1% vs. 12.5%) and grade 4 PVD (100% vs 68.7%). Additionally, NFLDs (O) (i.e., IRDs) were only present in the ILM tear group (52.4% vs. 0%).

CONCLUSIONS

Eyes with ILM tear exhibit several associated imaging biomarkers suggestive of progressive ERM contracture and/or vitreoretinal traction as compared with eyes without ILM tears including various forms of NFL defects and schisis of the nerve fiber layer. En face OCT, especially when widefield, may serve as a supportive tool to identify the various pathoanatomical lesions associated with ILM tears with single acquisition.

FINANCIAL DISCLOSURES

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

摘要

目的

描述伴有或不伴有内界膜（ILM）撕裂的视网膜前膜（ERM）患者眼睛的人口统计学、临床和OCT表面成像特征。

设计

回顾性病例系列研究。

研究对象

这项单机构研究纳入了101例患有ERM的患者的101只眼睛。

方法

这项单机构研究纳入了101例患有ERM的患者的101只眼睛。

主要观察指标

从电子病历中收集人口统计学和临床数据。对每例患者的ERM进行OCT表面成像检查并研究，确定ILM撕裂的发生率。还评估了与ILM撕裂相关的各种OCT表面成像生物标志物，包括神经纤维层缺损（NFLD），分为NFLD圆形（R），即血管旁视网膜内层缺损（PIRD），与NFLD椭圆形（O）（即视网膜内层凹陷[IRD]）。还评估了视网膜神经纤维层（SNFL）的劈裂和玻璃体后脱离（PVD）分级。

结果

在101只患有ERM的眼睛中，有21只（20.8%）发现了内界膜撕裂。伴有或不伴有ILM撕裂的ERM患者在人口统计学或临床特征上未观察到显著差异。然而，NFLD（R）（即PIRD）在ILM撕裂组中显著（P<0.05）更常见（80.9%对37.5%），而非ILM撕裂组。SNFL（57.1%对12.5%）和4级PVD（100%对68.7%）也是如此。此外，NFLD（O）（即IRD）仅出现在ILM撕裂组（52.4%对0%）。