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Abstract：
Background: To investigate anatomical and functional changes of the macula caused by epiretinal membrane (ERM) peeling procedures in patients with or without posterior vitreous detachment (PVD). Methods: This is a multicentric prospective observational study on thirty-seven (37) patients affected by symptomatic ERM who underwent 25-gauge pars plana vitrectomy (PPV), induction of a PVD (as needed) and peeling of both the internal limiting membrane (ILM) and ERM. Optical coherence tomography-angiography (OCT-A) (RS 3000, Nidek, Japan) and microperimetry (MP-3, Nidek, Japan) were performed; central retinal thickness (CRT), foveal avascular zone (FAZ) area and perimeter, vessel density and perfusion density, retinal sensitivity and fixation stability (as a total mean retinal sensitivity (MRS), and MRS in the ellipse area and bivariate contour ellipse area (BCEA)) were recorded at baseline and up to postoperative month 3. Results: Eyes were classified as having complete PVD (51.4%) or incomplete PVD (48.6%). At baseline, patients with incomplete PVD had worse best-corrected distance visual acuity (BCDVA), total MRS, MRS in the ellipse area and BCEA, and higher CRT than patients with complete PVD. At month 3, the differences in BCDVA between the two groups remained statistically significant, with patients with incomplete PVD having worse results (difference: 0.199 logMAR, p < 0.001). The difference in the MRS in the ellipse area was statistically significant at month 3 (-3.378 Db, p = 0.035), with greater improvement in patients with complete PVD. Conclusions: Our study shows that patients with incomplete PVD have worse conditions at baseline than patients with complete PVD, and the differences in visual acuity and retinal sensitivity were maintained postoperatively.
摘要：
背景：探讨视网膜前膜（ERM）剥离术对玻璃体后脱离（PVD）患者黄斑的解剖和功能变化。方法：这是一项多中心的前瞻性观察性研究，对37例（37例）有症状的ERM患者进行了25号平面玻璃体切除术（PPV），诱导PVD(根据需要)和剥离内界膜(ILM)和ERM。光学相干断层扫描-血管造影（OCT-A）（RS3000，Nidek，日本）和显微视野（MP-3，Nidek，日本）进行；中央视网膜厚度（CRT），中央凹无血管区（FAZ）面积和周长，血管密度和灌注密度，视网膜敏感性和固定稳定性(作为总平均视网膜敏感性(MRS)，在基线和术后3个月记录椭圆区域和双变量轮廓椭圆区域（BCEA）的MRS。结果:眼睛分为完全PVD(51.4%)或不完全PVD(48.6%)。在基线,不完全PVD患者的最佳矫正视力（BCDVA）较差，总MRS，椭圆区的MRS和BCEA,CRT高于完全PVD患者。在第3个月，两组之间的BCDVA差异仍具有统计学意义，不完全PVD患者的结果较差(差异：0.199logMAR，p<0.001)。第3个月椭圆区MRS差异有统计学意义(-3.378Db,p=0.035),完全PVD患者的改善更大。结论：我们的研究表明，不完全PVD患者的基线状况比完全PVD患者更差。术后保持视力和视网膜敏感度的差异。
