Abstract：
OBJECTIVE: To investigate the changes in the external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (IZ) integrity and their relationship with visual outcomes after idiopathic epiretinal membranes peeling.
METHODS: Clinical records of 150 eyes from 144 consecutive patients who underwent vitrectomy were reviewed. The status of IZ, EZ, and ELM was assessed by spectral-domain optical coherence tomography at baseline and 1, 4, 10, and 24 months postoperatively.
RESULTS: Sixty-one eyes presented with photoreceptor layer disruption preoperatively, and IZ disruption (40.7%) was the primary type. The best-corrected visual acuity (BCVA) in the photoreceptor disruption group was significantly lower than that in the intact group at baseline and the final follow-up. Of them, ELM + EZ + IZ disruption showed the worst BCVA (P = 0.001). After surgery, 62 eyes were observed with disruption aggravated. EZ + IZ disruption (51.0%) was the most frequent type at 1 month postoperatively. The eyes with longer symptom duration, better BCVA, earlier stage, thinner CFT at baseline, and combined cataract surgery more tended to be observed with photoreceptor damage progressed after surgery (P < 0.05). There was no significant difference in the final BCVA between the eyes with and without damage progressed (P = 0.332). Finally, 28.1% of the eyes recovered photoreceptor continuity. The eyes with foveal photoreceptor integrity restored had better BCVA than those remaining discontinuous (P < 0.001).
CONCLUSIONS: ERM-induced photoreceptor disruption mainly manifests as IZ disruption and has a negative effect on BCVA, whereas surgery mainly causes EZ and IZ disruption, which does not have a significant impact on the final BCVA.
METHODS: Clinical records of 150 eyes from 144 consecutive patients who underwent vitrectomy were reviewed. The status of IZ, EZ, and ELM was assessed by spectral-domain optical coherence tomography at baseline and 1, 4, 10, and 24 months postoperatively.
RESULTS: Sixty-one eyes presented with photoreceptor layer disruption preoperatively, and IZ disruption (40.7%) was the primary type. The best-corrected visual acuity (BCVA) in the photoreceptor disruption group was significantly lower than that in the intact group at baseline and the final follow-up. Of them, ELM + EZ + IZ disruption showed the worst BCVA (P = 0.001). After surgery, 62 eyes were observed with disruption aggravated. EZ + IZ disruption (51.0%) was the most frequent type at 1 month postoperatively. The eyes with longer symptom duration, better BCVA, earlier stage, thinner CFT at baseline, and combined cataract surgery more tended to be observed with photoreceptor damage progressed after surgery (P < 0.05). There was no significant difference in the final BCVA between the eyes with and without damage progressed (P = 0.332). Finally, 28.1% of the eyes recovered photoreceptor continuity. The eyes with foveal photoreceptor integrity restored had better BCVA than those remaining discontinuous (P < 0.001).
CONCLUSIONS: ERM-induced photoreceptor disruption mainly manifests as IZ disruption and has a negative effect on BCVA, whereas surgery mainly causes EZ and IZ disruption, which does not have a significant impact on the final BCVA.
摘要：
目的：为了研究外界膜（ELM）的变化，椭球区(EZ),特发性视网膜前膜剥离后，指间区（IZ）完整性及其与视觉结局的关系。
方法：回顾了144例连续行玻璃体切除术患者的150只眼的临床记录。IZ的状态，EZ,在基线和术后1,4,10和24个月时通过谱域光学相干断层扫描评估ELM.
结果：61只眼术前出现感光层破坏，IZ破坏（40.7%）是主要类型。在基线和最终随访时，光感受器破坏组的最佳矫正视力（BCVA）明显低于完整组。其中,ELM+EZ+IZ破坏显示最差的BCVA(P=0.001)。手术后,观察到62只眼破裂加重。EZ+IZ中断(51.0%)是术后1个月最常见的类型。症状持续时间较长的眼睛，更好的BCVA，早期阶段,基线时更薄的CFT，合并白内障手术更倾向于观察到术后光感受器损伤进展(P<0.05)。有损伤和无损伤的眼睛之间的最终BCVA没有显着差异（P=0.332）。最后,28.1%的眼睛恢复了感光体连续性。中央凹光感受器完整性恢复的眼睛比保持不连续的眼睛具有更好的BCVA(P<0.001)。
结论：ERM诱导的光感受器破坏主要表现为IZ破坏，对BCVA有负面影响，而手术主要导致EZ和IZ中断，这对最终的BCVA没有重大影响。
方法：回顾了144例连续行玻璃体切除术患者的150只眼的临床记录。IZ的状态，EZ,在基线和术后1,4,10和24个月时通过谱域光学相干断层扫描评估ELM.
结果：61只眼术前出现感光层破坏，IZ破坏（40.7%）是主要类型。在基线和最终随访时，光感受器破坏组的最佳矫正视力（BCVA）明显低于完整组。其中,ELM+EZ+IZ破坏显示最差的BCVA(P=0.001)。手术后,观察到62只眼破裂加重。EZ+IZ中断(51.0%)是术后1个月最常见的类型。症状持续时间较长的眼睛，更好的BCVA，早期阶段,基线时更薄的CFT，合并白内障手术更倾向于观察到术后光感受器损伤进展(P<0.05)。有损伤和无损伤的眼睛之间的最终BCVA没有显着差异（P=0.332）。最后,28.1%的眼睛恢复了感光体连续性。中央凹光感受器完整性恢复的眼睛比保持不连续的眼睛具有更好的BCVA(P<0.001)。
结论：ERM诱导的光感受器破坏主要表现为IZ破坏，对BCVA有负面影响，而手术主要导致EZ和IZ中断，这对最终的BCVA没有重大影响。
