目的:使用面部OCT评估特发性黄斑裂孔(MHs)眼的视网膜前异常组织(PAT)。
方法:回顾性,观察性研究。
方法:接受6×6-mm谱域OCT扫描的MH患者。
方法:使用自定义平板通过面部OCT图像检测视网膜前异常组织,定义为内界膜(ILM)前方6μm的前边界和ILM后方3μm的后边界。PAT定义为在面部OCT中观察到的任何异常组织。
方法:术前和术后PAT的特点。
结果:纳入60例MH患者的60只眼。51只眼睛接受了术前分析,46只眼进行了术后检查。手术前,48只(94%)眼的平均(标准偏差[SD])PAT为6.6(9.8)mm2。相应的横截面OCT显示PAT包括视网膜前段增生,血管外胶质细胞,和一条视网膜前超反射带.12只眼(24%)的视网膜前异常组织与孔(MH周围PAT)相邻,而其他人(36眼,76%)有零散分布(心外PAT)。周围MHPAT的眼睛的PAT面积大于带有外凹PAT的眼睛(P<0.0001)。与外凹PAT的眼睛相比,MH周围PAT患者的眼睛与男性相关(P=0.0059),基线视力(VA)较差(P=0.0002).在ILM剥离的眼睛(42眼),在1年的随访中,观察到术后从ILM剥离边缘向周边的PAT增生.术后2周PAT的平均面积(SD)为3.4(3.6)mm2,12个月时增加到12.1(6.4)mm2(P<0.0001)。然而,在4只接受玻璃体切除术但未进行ILM剥离的眼中,未观察到PAT升高.术后PAT大小与术后VA无关。
结论:En面部OCT显示大多数MHs患者的PAT。围MHPAT与不良VA相关,在男性患者中更常见。术后PAT增殖可能由ILM剥离引发,但它与更坏的VA无关。
To assess preretinal abnormal tissue (PAT) using en face OCT in eyes with idiopathic macular holes (MHs).
Retrospective, observational study.
Patients with MH who received 6 × 6-mm spectral-domain-OCT scans.
Preretinal abnormal tissue was detected by en face OCT images with a custom slab, defined with an anterior boundary of 6 μm anterior to the internal limiting membrane (ILM) and a posterior boundary at 3 μm posterior to the ILM. The PAT was defined as any abnormal tissues observed in en face OCT.
Characteristics of preoperative and postoperative PAT.
Sixty eyes with MH from 60 patients were included. Fifty-one eyes underwent preoperative analysis, and 46 eyes underwent postoperative examination. Before surgery, 48 (94%) eyes had a mean (standard deviation [SD]) PAT of 6.6 (9.8) mm2. The corresponding cross-sectional OCT showed PAT consisting of epiretinal proliferation, epivascular glia, and a preretinal hyperreflective band. Preretinal abnormal tissue was contiguous to the hole (peri-MH PAT) in 12 eyes (24%), whereas others (36 eyes, 76%) had a scattered distribution (extrafoveal PAT). The area of PAT was greater in eyes with a peri-MH PAT than in eyes with an extrafoveal PAT (P < 0.0001). Compared to the eyes with the extrafoveal PAT, the eyes with the peri-MH PAT were associated with men (P = 0.0059) and worse baseline visual acuity (VA) (P = 0.0002). In eyes with ILM peeling (42 eyes), postoperative PAT proliferation was observed from the edge of the ILM peeling toward the periphery over a 1-year follow-up. The mean (SD) area of PAT at 2 weeks after surgery was 3.4 (3.6) mm2 and increased to 12.1 (6.4) mm2 at 12 months (P < 0.0001). However, no PAT increase was observed in 4 eyes that underwent vitrectomy without ILM peeling. The postoperative PAT size was not associated with the postoperative VA.
En face OCT revealed PAT in most eyes with MHs. Peri-MH PAT was associated with worse VA and was seen more frequently in male patients. Postoperative PAT proliferation may be triggered by ILM peeling, but it is not associated with worse VA.