目的:评价特发性视网膜前膜(ERMs)合并视网膜神经纤维层裂开(sRNFL)患者在常规临床中的解剖和视觉预后。
方法:回顾性病例对照研究。
方法:2013年至2021年在Cole眼科研究所接受特发性ERM手术的患者。
方法:患者在手术前根据是否存在sRNFL进行分组。术前和术后数据收集有关视力(VA),中心子场厚度(CST)随时间的变化,和黄斑囊样水肿的存在。
方法:特发性ERM手术患者的sRNFL频率。
结果:总体而言,89例患者中有48例(53.9%)出现sRNFL。与无视网膜神经纤维层的患者相比,VA显着降低的视网膜神经纤维层的分裂(58.63±12.48vs.67.68±7.84ETDRS字母,分别为P<0.001)。在ERM移除后的最后一次随访中,sRNFL患者与无sRNFL患者的最终VA没有显着差异(71.16±2.93vs.74.11±2.76,P=0.467)。在介绍时,sRNFL患者的CST高于无sRNFL患者(454±10.01vs.436±0.23,P=0.23)。这种差异在去除ERM后的90天随访中仍然存在(402±8.08vs.375±10.19μm,P=0.043)。31例中有30例(96.7%)在术后第1周报告sRNFL的消退。
结论:在常规临床实践中,视网膜神经纤维层的分裂是>50%的特发性ERM的微观结构特征,并在术后表现和解剖意义上具有视觉意义。
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To evaluate the anatomic and visual outcomes of patients with idiopathic epiretinal membranes (ERMs) complicated by schisis of the retinal nerve fiber layer (sRNFL) in routine clinical practice.
Retrospective case-control study.
Patients undergoing idiopathic ERM surgery at Cole Eye Institute from 2013 to 2021.
Patients were grouped by the presence or absence of sRNFL before surgery. Preoperative and postoperative data were collected regarding visual acuity (VA), changes in central subfield thickness (CST) over time, and presence of cystoid macular edema.
Frequency of sRNFL in patients undergoing idiopathic ERM surgery.
Overall, 48 (53.9%) of 89 patients presented with sRNFL. Schisis of the retinal nerve fiber layer patients presented with significantly decreased VA compared with those without (58.63 ± 12.48 vs. 67.68 ± 7.84 ETDRS letters, P < 0.001, respectively). At the final follow-up after ERM removal, there was no significant difference in final VA in patients with sRNFL compared with those without (71.16 ± 2.93 vs. 74.11 ± 2.76, P = 0.467). At presentation, patients with sRNFL had greater CST than those without (454 ± 10.01 vs. 436 ± 0.23, P = 0.23). This difference persisted at the 90-day follow-up after ERM removal (402 ± 8.08 vs. 375 ± 10.19 μm, P = 0.043). The resolution of sRNFL was reported at postoperative week 1 in 30 (96.7%) of 31 cases.
Schisis of the retinal nerve fiber layer is a microstructural feature in > 50% of idiopathic ERMs in routine clinical practice and carries visual significance on presentation and anatomic significance postoperatively.
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