Kaluzny Jakub J, Zabel Przemyslaw, Suwala Karolina Anna, Jaworski Damian, Gebska-Toloczko Martyna, Woznicki Krzysztof, Pek-Grzybowska Renata
Department of Sensory Organ Studies, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Oftalmika Eye Hospital, Bydgoszcz, Poland.
Clin Ophthalmol. 2025 Aug 7;19:2587-2593. doi: 10.2147/OPTH.S524057. eCollection 2025.
To compare the location of microcystic macular edema (MME) with areas of retinal nerve fiber layer (RNFL) damage in the macula detected on en-face SDOCT in eyes that underwent pars plana vitrectomy (PPV) due to the epiretinal membrane (ERM).
Thirty-five eyes were enrolled at least 6 months after PPV with removal of ERM and inner limiting membrane (ILM). In each eye, en-face SDOCT and microperimetry were performed. The area of RNFL damage was measured and compared with the position of MME and correlated with the volume of retinal layers and retinal sensitivity (AT).
MME was observed in 17 eyes (48.6%) in the area devoid of ILM, often in places with arcuate damage to the RNFL bundle. The mean area of RNFL damage in eyes with MME was 9.03 ± 5.3 mm and was significantly larger than in eyes where microcysts were not present, where it measured 3.92 ± 3.3 mm. A significant negative correlation was observed between the area of RNFL damage and GCL volume and AT.
The topographic analysis of the MME position in eyes after PPV due to ERM confirmed the association of this pathology with ganglion cells and RNFL damage related to the removal of the ILM and ERM. There are probably two pathways leading to the development of MME: one starting from Muller cell damage during ILM peeling and the other due to retrograde death of ganglion cells in the areas of arcuate RNFL defects.
比较因视网膜前膜（ERM）接受玻璃体切割术（PPV）的眼中，微囊性黄斑水肿（MME）的位置与经正面扫描光相干断层扫描（SDOCT）检测到的黄斑区视网膜神经纤维层（RNFL）损伤区域。
纳入35只在PPV联合ERM及内界膜（ILM）切除术后至少6个月的眼睛。对每只眼睛进行正面SDOCT和微视野检查。测量RNFL损伤面积，并与MME的位置进行比较，同时与视网膜各层体积和视网膜敏感度（AT）相关联。
17只眼睛（48.6%）在无ILM的区域观察到MME，常出现在RNFL束呈弓形损伤的部位。存在MME的眼睛中RNFL损伤的平均面积为9.03±5.3平方毫米，显著大于无微囊肿的眼睛，后者为3.92±3.3平方毫米。观察到RNFL损伤面积与神经节细胞层（GCL）体积和AT之间存在显著负相关。
对因ERM接受PPV术后眼睛中MME位置的地形图分析证实了这种病变与神经节细胞以及与ILM和ERM切除相关的RNFL损伤之间的关联。可能有两条导致MME发生的途径：一条始于ILM剥离过程中Müller细胞的损伤，另一条是由于弓形RNFL缺损区域神经节细胞的逆行性死亡。
