Lee Chang Hwan, Choi Seung Woo, Lee Eun Kyoung, Yoon Chang Ki, Park Un Chul, Park Kyu Hyung, Go Sojung, Park Sang Jun, Bae Kunho
Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea.
Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea.
Sci Rep. 2025 Jul 1;15(1):21415. doi: 10.1038/s41598-025-06771-7.
Epiretinal membrane (ERM) can arise idiopathically or secondary to uveitis, each driven by distinct pathophysiological mechanisms. Because ERMs exert tractional forces that distort both the retina and its vasculature, vascular geometry can serve as an indirect marker of the tractional forces acting on the retina. This study aimed to evaluate the associations between postoperative changes in retinal vascular geometry and functional outcomes in patients with idiopathic and uveitic epiretinal membrane (iERM and uERM). A retrospective analysis was performed on 72 eyes (42 iERM, 30 uERM) that underwent pars plana vitrectomy for ERM. Retinal vascular geometric parameters, including arterial and venous angles, branching angles, and tortuosity, were quantitatively measured using conventional retinal fundus photographs. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were measured preoperatively and at 1 and 6 months postoperatively. The primary outcome was the comparison of postoperative changes in retinal vascular geometry between iERM and uERM, while the secondary outcome assessed improvements in BCVA, M-score, and CFT, and their correlation with vascular changes. Greater postoperative changes in arterial angle were significantly associated with improvements in BCVA and CFT. The iERM group exhibited more pronounced changes in retinal vascular geometry than the uERM group, particularly in branching venous angles and venous tortuosity. These differences became more evident over time. In conclusion, this study demonstrates that postoperative changes in retinal vascular geometry differ between patients with iERM and uERM, with more significant changes observed in iERM. These findings provide valuable insight into the distinct recovery mechanisms in iERM and uERM, emphasizing the roles of tractional forces and inflammation in shaping postoperative outcomes.
视网膜前膜（ERM）可原发性发生，也可继发于葡萄膜炎，二者由不同的病理生理机制驱动。由于ERM会施加牵拉力，使视网膜及其血管系统变形，血管几何形态可作为作用于视网膜的牵拉力的间接标志物。本研究旨在评估特发性和葡萄膜炎性视网膜前膜（iERM和uERM）患者术后视网膜血管几何形态变化与功能预后之间的关联。对72只接受ERM玻璃体切除术的眼睛（42只iERM，30只uERM）进行了回顾性分析。使用传统的视网膜眼底照片定量测量视网膜血管几何参数，包括动静脉夹角、分支夹角和迂曲度。术前及术后1个月和6个月测量最佳矫正视力（BCVA）和中心凹厚度（CFT）。主要结果是比较iERM和uERM术后视网膜血管几何形态的变化，次要结果评估BCVA、M评分和CFT的改善情况及其与血管变化的相关性。术后动脉夹角的更大变化与BCVA和CFT的改善显著相关。iERM组视网膜血管几何形态的变化比uERM组更明显，尤其是在分支静脉夹角和静脉迂曲度方面。随着时间的推移，这些差异变得更加明显。总之，本研究表明，iERM和uERM患者术后视网膜血管几何形态的变化不同，iERM中观察到的变化更显著。这些发现为iERM和uERM不同的恢复机制提供了有价值的见解，强调了牵拉力和炎症在塑造术后预后中的作用。
