[1]黄志坚,陈晓,洪玲,等.有无黄斑中心凹下沉积物的特发性黄斑前膜治疗效果比较[J].眼科新进展,2019,39(12):1174-1177.[doi:10.13389/j.cnki.rao.2019.0270]
　HUANG Zhi-Jian,CHEN Xiao,HONG Ling,et al.Subfoveal deposits in idiopathic macular epiretinal membrane[J].Recent Advances in Ophthalmology,2019,39(12):1174-1177.[doi:10.13389/j.cnki.rao.2019.0270]
点击复制

有无黄斑中心凹下沉积物的特发性黄斑前膜治疗效果比较/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年12期
页码:
1174-1177
栏目:
应用研究
出版日期:
2019-12-05

文章信息/Info

Title:
Subfoveal deposits in idiopathic macular epiretinal membrane
作者:
黄志坚; 陈晓; 洪玲; 曾苗
430070　湖北省武汉市，中国人民解放军中部战区总医院
Author(s):
HUANG Zhi-Jian; CHEN Xiao; HONG Ling; ZENG Miao
Department of Ophthalmology，Central War Zone General Hospital，Wuhan 430070，Hubei Province，China
关键词:
特发性黄斑前膜; 黄斑中心凹视网膜厚度; 玻璃体切割; 黄斑中心凹下沉积物
Keywords:
idiopathic macular epiretinal membrane; central macular thickness; vitrectomy; subfoveal deposits
分类号:
R774.5
DOI:
10.13389/j.cnki.rao.2019.0270
文献标志码:
A
摘要:
目的　对比观察特发性黄斑前膜有无黄斑中心凹下沉积物手术前后情况。方法　回顾性非随机临床研究。41例41眼特发性黄斑前膜患者分为2组，组1为有黄斑中心凹下沉积物者8例8眼，组2为没有黄斑中心凹下沉积物者33例33眼。所有患者均接受标准经睫状体平坦部三通道25G玻璃体切割联合内界膜剥除术。对比观察两组术前和术后1个月、3个月、6个月的最佳矫正视力（best corrected visual acuity，BCVA）和黄斑中心凹视网膜厚度（central macular thickness，CMT）情况，同时观察并发症发生情况。结果　术后6个月，组1、组2 BCVA分别为（0.65±0.24）logMAR、（0.54±0.26）logMAR，均较术前明显提高，差异有统计学意义（均为P=0.00）；两组间术前、术后6个月BCVA差异均无统计学意义（均为P>0.05）。术后6个月，组1、组2 CMT分别为（288.38±64.64）μm、（299.85±37.19）μm，均较术前显著降低，差异均有统计学意义（均为P=0.00）；两组间术前、术后6个月CMT相比差异均无统计学意义（均为P>0.05）。随访期间，所有患眼均未见黄斑前膜复发。结论　25G玻璃体切割联合内界膜剥除治疗特发性黄斑前膜，可稳定提高患者的BCVA，促进黄斑结构的恢复，有无黄斑中心凹下沉积物对术后BCVA、CMT无明显影响。
Abstract:
Objective　To compare the preoperative and postoperative course of subfoveal deposits in idiopathic macular epiretinal membrane(IEM).Methods　This retrospective，non-randomised，comparative clinical study.We divided 41 patients (41 eyes) with IEM into 8 eyes of 8 patients with subfoveal deposits as group 1 and 33 eyes of 33 patients without subfoveal deposits as group 2.All patients were treated by 25G micro-incision vitrectomy and internal limiting membrane (ILM) removal.The changes of the best corrected visual acuity(BCVA)，central macular thickness(CMT) were compared at preoperative and postoperative 1，3，6 months.Results　At the 6 months after surgery，the mean BCVA was (0.65±0.24)logMAR in group 1，and (0.54±0.26)logMAR in group 2，significant postoperative improvements were observed in both groups(both P=0.00)；the difference was not significant in both groups at preoperative and postoperative 6 months(both P>0.05).The mean CMT was (288.38±64.64)μm in group 1，and (299.85±37.19)μm in group 2，significant postoperative improvements were observed in both groups(both P=0.00)；the difference was not significant in both groups at preoperative and postoperative 6 months(both P>0.05).No patients of IEM was recurrenced during in 6 months.Conclusion　25G micro-incision vitrectomy and ILM removal is an efficient and safe treatment for IEM，they can improve BCVA and foveal morphology.Subfoveal deposits does not significantly influence on postoperative BCVA and CMT.

参考文献/References:

［1］　MCCARTY D J，MUKESH B N，CHIKANI V，WANG J J，MITCHELL P，TAYLOR H R，et al.Prevalence and associations of epiretinal membranes in the visual impairment project［J］.Am J Ophthalmol，2005，140（2）：288-294.
［2］　MITCHELL P，SMITH W，CHEY T，WANG J J，CHANG A.Prevalence and associations of epiretinal membranes.The blue mountain eye study［J］.Ophthalmology，1997，104(6)：1033-1040.
［3］　DONATI G，KAPETANIOS A D，POURNARAS C J.Complications of surgery for epiretinal membranes［J］.Graefes Arch Clin Exp Ophthalmol，1998，236(10)：739-746.
［4］　GOVETTO A，VIRQILI G，RODRIQUEZ F J，FIQUEROA M S，SARRAF D，HUBSCHMAN J P.Functional and anatomical significance of the ectopic inner foveal layers in eyes with idiopathic epiretinal membranes：Surgical results at 12 months［J］.Retina，2019，39(2)347-357.
［5］　GOVETTO A，BHAVSAR K V，VIRGILI G，GERBER M J，FREUND K B，CURCIO C A，et al.Tractional abnormalities of the central foveal bouquet in epiretinal membranes：clinical spectrum and pathophysiological perspectives［J］.Am J Ophthalmol，2017，184：167-180.
［6］　FRASER-BELL S，YING-LAI M，KLEIN R，VARMA R.Prevalence and associations of epiretinal membranes in latinos：the Los Angeles Latino Eye Study［J］.Invest Ophthalmol Vis Sci，2004，45(6)：1732-1736.
［7］　BAE J H，SONG S J，LEE M Y.Five-year incidence and risk factors for idiopathic epiretinal membranes［J］.Retina，2019，39(4)：753-760.
［8］　DUPAS B，TADAYONI R，ERQINAY A，MASSIN P，GAUDRIC A.Subfoveal deposits secondary to idiopathic epiretinal membranes［J］.Ophthalmology，2009，116(9)：1794-1798.
［9］　TSUNODA K，WATANABE K，AKIYAMA K，USUI T，NODA T.Highly reflective foveal region in optical coherence tomography in eyes with vitreomacular traction or epiretinal membrane［J］.Ophthalmology，2012，119(3)：581-587.
［10］　MARIOTTI C，NICOLAI M，LONGO A，VITI F，BAMBINI E，SAITTA A.et al.Peripapillary retinal nerve fiber thickness changes after vitrectomy for epiretinal membrane in eyes with and with and without vitreous detachment［J］.Retina，2017，37(12)：2304-2309.
［11］　NIWA T，TERASAKI H，KONDO M，PIAO C H，SUZUKI T，MIYAKE Y.Function and morphology of macula before and after removal of idiopathic epiretinal membrane［J］.Invest Ophthalmol Vis Sci，2003，44(4)：1652-1656.

相似文献/References:

[1]毛新帮 游志鹏 赵菊莲.应用25G经结膜无缝合玻璃体切割系统治疗特发性黄斑前膜[J].眼科新进展,2013,33(3):000.
[2]刘菊,刘武.特发性黄斑前膜术后解剖与功能恢复的预期影响因素[J].眼科新进展,2014,34(8):798.[doi:10.13389/j.cnki.rao.2014.0221]
　LIU Ju,LIU Wu.Prognostic effective factors for visual function and macular anatomy recovery after idiopathic epiretinal membrane surgery[J].Recent Advances in Ophthalmology,2014,34(12):798.[doi:10.13389/j.cnki.rao.2014.0221]
[3]刘明,谢安明,陈丽. 特发性黄斑前膜术后视功能及黄斑区形态结构的变化[J].眼科新进展,2014,34(9):872.[doi:10.13389/j.cnki.rao.2014.0241]
[4]旷琳,杨蕾蕾.白内障超声乳化人工晶状体植入术后黄斑中心凹视网膜厚度与最佳矫正视力的相关性研究[J].眼科新进展,2014,34(12):1167.[doi:10.13389/j.cnki.rao.2014.0324]
　KUANG Lin,YANG Lei-Lei.Relationship between macular foveal retinal thickness and BCVA after phacoemulsification and IOL implantation[J].Recent Advances in Ophthalmology,2014,34(12):1167.[doi:10.13389/j.cnki.rao.2014.0324]
[5]王净莉,万新顺,李彦.间接光凝和直接光凝治疗中心性浆液性脉络膜视网膜病变的疗效对比观察[J].眼科新进展,2016,36(5):477.[doi:10.13389/j.cnki.rao.2016.0128]
　WANG Jing-Li,WAN Xin-Shun,LI Yan.Comparative evaluation of indirect and direct laser photocoagulation for central serous chorioretinopathy[J].Recent Advances in Ophthalmology,2016,36(12):477.[doi:10.13389/j.cnki.rao.2016.0128]
[6]赵婷婷,周民稳,施靖容,等.特发性黄斑前膜术后黄斑区结构改变与视功能的相关性[J].眼科新进展,2016,36(6):536.[doi:10.13389/j.cnki.rao.2016.0142]
　ZHAO Ting-Ting,ZHOU Min-Wen,SHI Jing-Rong,et al.Correlation between macular structure and visual function after idiopathic epiretinal membrane surgery[J].Recent Advances in Ophthalmology,2016,36(12):536.[doi:10.13389/j.cnki.rao.2016.0142]
[7]郁艳萍,刘武.脉络膜厚度与特发性黄斑裂孔和黄斑前膜关系的研究进展[J].眼科新进展,2016,36(9):898.[doi:10.13389/j.cnki.rao.2016.0241]
　YU Yan-Ping,LIU Wu.Research progress on relationship between choroidal thickness and idiopathic macular hole , epiretinal membrane[J].Recent Advances in Ophthalmology,2016,36(12):898.[doi:10.13389/j.cnki.rao.2016.0241]
[8]杨怡,李克勤,牛梅民,等.无糖尿病视网膜病变糖尿病患者黄斑区视网膜厚度与病程及血糖水平的相关性研究[J].眼科新进展,2017,37(7):654.[doi:10.13389/j.cnki.rao.2017.0166]
　YANG Yi,LI Ke-Qin,NIU Mei-Min,et al.Correlation between macular thickness and course of disease，blood glucose level in patients with diabetic retinopathy without diabetes mellitus[J].Recent Advances in Ophthalmology,2017,37(12):654.[doi:10.13389/j.cnki.rao.2017.0166]
[9]陈懿,曾键,郑磊,等.黄斑前膜分级法对特发性黄斑前膜手术效果的评估：基于OCT图像的研究[J].眼科新进展,2018,38(3):262.[doi:10.13389/j.cnki.rao.2018.0061]
　CHEN Yi,ZENG Jian,ZHENG Lei,et al.Assessment of outcomes of idiopathic macular epiretinal membrane based on preoperative classification of the epiretinal membrane with OCT[J].Recent Advances in Ophthalmology,2018,38(12):262.[doi:10.13389/j.cnki.rao.2018.0061]
[10]冷云霞,张柳,张蒙,等.早产儿视网膜病变黄斑中心视网膜微血管形态特征：基于光学相干断层扫描血管成像（OCTA）的观察[J].眼科新进展,2018,38(4):357.[doi:10.13389/j.cnki.rao.2018.0083]
　LENG Yun-Xia,ZHANG Liu,ZHANG Meng,et al.Observation of central macular retinal microvascular network morphology of retinopathy of prematurity by optical coherence tomography angiography[J].Recent Advances in Ophthalmology,2018,38(12):357.[doi:10.13389/j.cnki.rao.2018.0083]

更新日期/Last Update: 2019-12-17