ABSTRACT
AIM: To observe the postoperative changes in macular morphological structure and blood flow density of patients with idiopathic macular epiretinal membrane(IMEM)by optical coherence tomography angiography(OCTA), and explore their correlation with visual acuity.METHOD: Prospective study. A total of 45 cases(45 eyes)with IMEM admitted to our hospital from January 2020 to July 2021 were included. The best corrected visual acuity(BCVA), central macular area thickness(CMT), foveal avascular zone(FAZ)area and changes in blood flow density of superficial capillary plexus(SCP)were observed at 1mo, 1, 3 and 6mo before and after operation.RESULT: The BCVA at 1wk after operation had no significant change compared with preoperative data(P>0.05), while it was improved at other time points(P<0.05). The CMT measured at 1wk after operation was thickened significantly(P<0.05), while it was significantly decreased at 1mo, 3mo and 6mo after operation(P<0.05). The FAZ area measured at 1wk and 1mo after operation had no significant change(P>0.05), while it was significantly enlarged at 3 and 6mo after operation(P<0.05). The SCP measured at 1wk, 1 and 3mo after operation had no significant change(P>0.05), while it was significantly decreased at 6mo after operation(P<0.05). BCVA measured at 3 and 6mo after operation was positively correlated with CMT(r=0.457, 0.615, P=0.032, 0.012).CONCLUSION: The visual acuity of patients with IMEM recovered quickly within 1mo after operation, and then it tended to be stable. However, the recovery of macular foveal morphology and blood flow distribution was slower than that of visual acuity, and there was no obvious correlation with visual acuity.
ABSTRACT
@#AIM: To analyze the changes of the epiretinal membrane(ERM)stage, macular status and best corrected visual acuity(BCVA, LogMAR)in cataract patients with idiopathic macular epiretinal membrane(IERM)before and after cataract surgery.METHODS:We conducted a single center retrospective observational case series of patients that underwent sequential cataract and idiopatic ERM surgeries from March 2016 to May 2019 in Anyang Eye Hospital. Full data were obtained for 51 patients(54 eyes).Preoperative and postoperative 1mo ERM stage, central macular edema(CME), central macular thickness(CMT), macular volume(MV), ellipsoid zone disruption, occurrence of neurosensory detachment(NSD)and BCVA were analyzed.RESULTS:In this group of patients, 5 eyes(9%)had ERM grade 1, 23 eyes(43%)had ERM grade 2, 21 eyes(39%)had ERM grade 3, and 5 eyes(9%)had ERM grade 4 before surgery; ERM graded 1mo after surgery were keeping steady. Compared with before operation(0.45±0.16),there was no significant change in BCVA(0.47±0.17)at 1mo after operation(<i>P</i>>0.05), but the incidence of CME, ellipsoid band interruption and NSD were significantly higher than those before operation(<i>P</i><0.05). CONCLUSION: We suggest that phacoemulsification did not significantly accelerate ERM progression and affect BCVA, but patients underwent cataract surgery in the presence of epiretinal membranes need tight follow up to treat and control eventual macular infammatory changes and eventual prompt vitrectomy if BCVA was threatened.
ABSTRACT
@#AIM: To analyze the effects of vitrectomy and macular epiretinal membrane dissection combined with or without internal limiting membrane(ILM)peeling on choroid thickness, vision and metamorphopsia in patients with idiopathic macular epiretinal membrane(IMEM).<p>METHODS: Totally 88 patients(88 eyes)with IMEM admitted to the hospital were selected between January 2016 and January 2020. They were divided into group A and group B by random number table method with 44 eyes in each group. Patients in group A were treated with vitrectomy and macular epiretinal membrane dissection combined with ILM peeling, while patients in group B were treated with vitrectomy and macular epiretinal membrane dissection. The choroid thickness, vision, metamorphopsia, central macular thickness(CMT), ellipsoid zone(EZ)continuity were compared between the two groups.<p>RESULTS: Compared with preoperative, the sub-foveal choroidal thickness(SFCT), choroidal thickness 1 000μm from nasal side central of fovea(NFCT)and choroidal thickness 1 000μm from temporal side central of fovea(TFCT)were significantly reduced in the two groups at 3mo and 6mo after operation(<i>P</i><0.05), but there was no statistically significant difference between the groups(<i>P</i>>0.5). Compared with preoperative, the best corrected visual acuity(BCVA)LogMAR was reduced, while mean sensitivity(MS)was increased in the two groups. The number of scotoma points(SP)increased in group A and decreased in group B. Group A had significantly lower MS and higher SP than group B at 1mo, 3mo, and 6mo after operation(<i>P</i><0.05). Compared with preoperative, the M scores(Angle of view when horizontal and vertical variability begins to disappear)and average M scores of the two groups were significantly reduced at 3mo and 6mo after operation, without statistically significant differences between the groups(<i>P</i>>0.05). Compared with preoperative, CMT was significantly reduced in the two groups at 1, 3 and 6mo after operation. The ratio of EZ continuity in group A at 1mo after operation was significantly lower than that before operation. The CMT of group A was larger than that of group B at 3mo and 6mo after operation(<i>P</i><0.05). No statistically significant differences were found in the ratio of EZ continuity and the incidence of complications between the groups(<i>P</i>>0.05).<p>CONCLUSION: Vitrectomy and macular epiretinal membrane dissection combined with or without ILM peeling both can improve vision and metamorphopsia in patients with IMEM, with similar effects on choroid thickness and safety. However, combined use of ILM peeling will lower MS and increase SP as well as CMT. Therefore, it has no significant advantages in the treatment of patients with IMEM.
ABSTRACT
@#AIM:To compare the changes of macular microcirculation in eyes with idiopathic and diabetic macular epiretinal membrane(ERM)before and after pars plana vitrectomy(PPV), and to evaluate the prognosis of the two types of ERM.<p>METHODS:We conducted a retrospective study on 24 patients(24 eyes), 12 patients(12 eyes)with idiopathic macular epiretinal membrane(iERM)and 12 patients(12 eyes)with diabetic macular epiretinal membrane(dERM)who underwent PPV combined with ERM and internal limiting membrane(ILM)peeling from April 2020 to July 2020. In addition, 16 contralateral healthy eyes of iERM patients who underwent PPV combined with ERM and ILM removal from September 2019 to July 2020 were selected as the normal control group. All patients were followed up for more than 3mo. The area of foveal avascular zone(FAZ)and the macular vascular density(MVD), including superficial macular vascular density(SVD)and deep macular vascular density(DVD)were compared before and after surgery. And the prognosis was also analysed.<p>RESULTS: The area of FAZ in the iERM group and dERM group before surgery were significantly smaller than that in the control group(<i>P</i><0.05); The total SVD in the iERM and dERM groups were lower than that in the control group, and the dERM group was lower than that in the iERM group, but no statistically significant difference was found. The total DVD in the iERM and dERM groups was significantly lower than that in the control group(<i>P</i><0.05). The foveal SVD in the iERM was significantly higher than that in the dERM and control groups, and the foveal DVD in the iERM was significantly higher than that in the control group(<i>P</i><0.05). The parafoveal SVD in the iERM and dERM groups were lower than that in the control group, but only the difference was obvious between the dERM and the control group(<i>P</i><0.05). The parafoveal DVD in the iERM and dERM groups were significantly lower than that in the control group(<i>P</i><0.05). Postoperative visual acuity was significantly improved in the iERM group and dERM group(<i>P</i><0.05), but the SVD was barely changed. The total and parafoveal DVD in the iERM group were statistically higher than those before surgery(<i>P</i><0.05). DVD in the dERM group was higher than it was before surgery, but with no statistically difference. There were no differences in the visual acuity, SVD and DVD between the iERM and dERM groups after operation.<p>CONCLUSION: The changes of macular microcirculation in dERM were more obvious than those in iERM. DVD in the iERM patients was improved at the early stage after operation, while the improvement was not obvious in the dERM patients.
ABSTRACT
@#AIM: To explore the risk factors that affect visual function recovery in patients with idiopathic macular epiretinal membrane(IMEM)undergoing internal limiting membrane peeling(ILMP).<p>METHODS: This study retrospectively reviewed 118 patients(118 eyes)with IMEM who underwent ILMP in the hospital between January 2016 and April 2020. The patients were followed up for 6mo after surgery to evaluate curative effect. Changes in visual acuity before surgery and at 1, 3 and 6mo after surgery, metamorphopsia degree, mean central foveal thickness and volume of macular area were observed. The correlation of mean central foveal thickness and volume of macular area before and after surgery with postoperative visual acuity and metamorphopsia scores was analyzed. The risk factors for poor visual function recovery after surgery were evaluated.<p>RESULTS: In this study, 96 eyes obtained good visual function recovery, and the improvement rate was 81.4%. At 1, 3 and 6mo after surgery, visual acuity was significantly improved(<i>P</i><0.05), metamorphopsia score in horizontal direction, mean central foveal thickness and volume of macular area were significantly reduced(<i>P</i><0.05). The mean central foveal thickness and volume of macular area before surgery and at 6mo after surgery were negatively correlated with visual acuity at 6mo after surgery(<i>P</i><0.05), but positively correlated with metamorphopsia score in horizontal direction(<i>P</i><0.05). The course of IMEM, preoperative corrected visual acuity, preoperative horizontal or vertical metamorphopsia, and preoperative macular edema were influencing factors of visual function recovery after surgery(all <i>P</i><0.05). Poor preoperative corrected visual acuity(<i>OR</i>=3.062), horizontal metamorphopsia(<i>OR</i>=2.438)and preoperative macular edema(<i>OR</i>=2.000)were risk factors for poor visual function recovery.<p>CONCLUSION: The curative of ILMP is effect on IMEM, which can effectively improve visual acuity of operative eyes and reduce metamorphopsia. The longer the course of disease, the worse the preoperative corrected visual acuity, and the more severe the preoperative metamorphopsia, the worse the visual function recovery in patients with preoperative macular edema after ILMP.
ABSTRACT
OBJECTIVE@#To investigate the value of hand-held retinal optometer and optical coherence tomography (OCT) in predicting postoperative visual acuity in patients with age-related cataract and idiopathic macular epiretinal membrane.@*METHODS@#We retrospectively analyzed the data of patients undergoing phacoemulsification combined with intraocular lens implantation for age-related cataract in our hospital from January, 2019 to April, 2020.Preoperative examination detected idiopathic macular epiretinal membrane in 45 of the patients (52 eyes) with lens opacity grade C2N2P1 according to LOCSⅡ lens opacity classification criteria.Based on the thickness of the macular fovea, the eyes were divided into group A (9 eyes) with macular thickness 400 μm.The best corrected visual acuity and retinal visual acuity before operation and the best corrected visual acuity on the first day and at 3 months after the surgery were compared among the 3 groups.The consistency between the preoperative retinal vision and the best corrected vision at 3 months after the surgery was analyzed.@*RESULTS@#The best corrected visual acuity at one day and 3 months after the surgery differed significantly from that before the surgery in all the 3 groups (@*CONCLUSIONS@#For patients with cataract and idiopathic macular epiretinal membrane, phacoemulsification combined with intraocular lens implantation can improve postoperative vision.Hand-held retinal optometer can accurately assess postoperative vision in patients with stage C2N2P1 cataract.Patients with a macular thickness >400 μm caused by idiopathic macular epiretinal membrane are likely to have poor postoperative visual outcomes.
Subject(s)
Humans , Cataract/diagnostic imaging , Epiretinal Membrane/surgery , Retrospective Studies , Tomography, Optical Coherence , Visual Acuity , VitrectomyABSTRACT
@#AIM: To evaluate the disruption degree of macular fovea structure by pre-operation SD-OCT examination and establish a new method of IMEM. Thus, to analysis the value of this method for predicting the visual functional prognosis of cataract patients complicated with idiopathic macular epiretinal membrane(IMEM)after cataract surgery alone.<p>METHODS: Totally 64 patients(80 eyes)diagnosed as cataract with IMEM, who simply underwent phaco cataract extraction combined with intraocular lens implantation were included in this study. These patients were admitted in Shenzhen Eye Hospital from October 2017 to November 2018. IMEM was divided into 4 stages based on the damage degree of macular fovea structure by pre-operative SD-OCT examination. The best corrected visual acuity(BCVA), mean retinal sensitivities(MS), central macular thickness(CMT)and the progression rate of IMEM in all the patients were compared and analyzed before and 3mo after the cataract operation.<p>RESULTS: With the IMEM grade rised, the epiretinal membranes became more obvious, the disruption of retinal layers and loss of the foveal depression became more serious on the SD-OCT image. The LogMAR BCVA of pre-operation and 3mo after cataract surgery progressively rised with the increasing of IMEM grade, and the differences were statistically significant(<i>F</i>=37.72, 26.43, <i>P</i><0.001). Otherwise, The MS of pre-operation and 3mo after cataract surgery progressively declined with the increasing of IMEM grade, and the differences were statistically significant(<i>F</i>=43.77, 28.96, <i>P</i><0.001). The change of CMT was not consistent with the progression rate of IMEM in 3mo after operation. There was no significant difference in CMT(<i>P</i>>0.05), but the progression rate of IMEM was increased significantly with the IMEM grading(χ<sup>2</sup><sub>Trend</sub>=12.59, <i>P</i><0.001).<p>CONCLUSION: The new classification method was created for IMEM by SD-OCT will help to predict the visual functional prognosis for cataract patients complicated with IMEM after cataract surgery.
ABSTRACT
@#AIM: To study the effect of vitrectomy combined with macular epiretinal membrane peeling on visual acuity, central macular thickness(CMT)and metamorphopsia degree in patients with idiopathic macular epiretinal membrane(IMEM).<p>METHODS: Totally 31 cases(31 eyes)of patients with IMEM were treated with vitrectomy combined with macular epiretinal membrane peeling, and the best corrected visual acuity(BCVA), CMT, ellipsoid zone(IS/OS)connectivity and macular morphology were examined before and after operation. The treatment effect was assessed, and the relationship between BCVA, macular structure and morphology before and after operation was studied. All the factors that might affect the surgical outcomes were analyzed.<p>RESULTS: The mean BCVA and CMT were 0.59±0.14 and 429.35±86.17μm respectively before operation, and were decreased to 0.38±0.09 and 304.87±62.54μm at 6mo after operation(<i>P</i><0.05). The metamorphopsia degree after operation was gradually decreased, and the metamorphopsia degree at 1, 3 and 6mo after operation was lower than before operation(<i>P</i><0.008). At 1mo after operation, the IS/OS connectivity ratios were 65%, and there was no significant difference compared with that before operation with 52%(<i>P</i>>0.008). The ratio of IS/OS connectivity was 81% and 90% at 3mo and 6mo after operation, and the difference was statistically significant compared with that before operation(<i>P</i><0.008). There was significant difference in the macular morphology at different time after operation(<i>P</i><0.008). The proportions of patients with normal macular morphology at 1, 3 and 6mo after operation were 26%, 52% and 77% respectively, and the differences were statistically significant compared with before operation(<i>P</i><0.008). Pearson or Spearman correlation analysis showed postoperative BCVA in IMEM patients was positively correlated with preoperative BCVA and postoperative CMT(<i>P</i><0.05), but that was negatively correlated with preoperative macular morphology, preoperative and postoperative IS/OS connectivity and postoperative macular morphology(<i>P</i><0.05).<p>CONCLUSION: Vitrectomy combined with macular epiretinal membrane peeling can significantly reduce the CMT of patients with IMEM, and improve the IS/OS connectivity and macular morphology, so as to improve the visual acuity and reduce the metamorphopsia degree.
ABSTRACT
@#AIM: To study the changes of choroidal thickness and the relationship between visual function and choroidal thickness before and after idiopathic epiretinal membrane surgery.<p>METHODS: From January 2016 to December 2017, 30 patients(30 eyes)with idiopathic macular membrane who underwent surgical treatment in our hospital were selected to clinical study. All patients underwent TSV25G PPV with membrane and ILM peeling, patients were followed up by best corrected visual acuity(BCVA)and subfoveal choroidal thickness(SFCT)in preoperative and postoperative 1wk, 1mo and 3mo. We performed statistical analyses using SPSS22.0, for the evaluation of BCVA and SFCT, we compared the mean differences of preoperative and postoperative measurements. On the other hand, we estimated the correction relationship between BCVA and SFCT.<p>RESULTS: The BCVA at 3mo after operation was significantly higher than that before operation(<i>P</i>=0.011). We found a significant correlation between preoperative and postoperative 3mo BCVA(<i>r</i>=0.610, <i>P</i><0.01), postoperative 1wk,1mo, 3mo showed no significant difference with preoperative SFCT(<i>P</i>=0.999). We found no significant correlation between BCVA and SFCT.<p>CONCLUSION: There was no significant change in choroid thickness after surgery, and also no significant correlation between visual function and choroid thickness.
ABSTRACT
@#Idiopathic macular epiretinal membrane(IMEM)is a common macular area disease associated with age and characterized by symptoms of decreased visual acuity and metamorphopsia. With the acceleration of aging population, the incidence of IMEM is also increasing year by year. At present, its exact pathogenesis is not clear, and there is no effective drug therapy. Vitrectomy is an effective treatment, but the improvement of postoperative visual function is very different. This article reviews the pathogenesis and factors related to prognosis in patients with IMEM, in order to adopt more accurate and effective preventive and therapeutic measures.
ABSTRACT
Objective To evaluate the accuracy of intraocular lens (IOL) power calculation using IOL-Master in patients underwent phacoemulsification and vitrectomy for idiopathic macular epiretinal membrane (IMEM) concurrent with age-related cataract (ARC).Methods A prospective study was designed.A total of 32 patients (32 eyes) with ARC (ARC group) and 30 patients (30 eyes) with ARC and IMEM (ARC+IMEM group) were enrolled from March 2013 to July 2015 in the Hangzhou District of Eye Hospital of Wenzhou Medical University.All the surgeries were performed by the same experienced surgeon and the same IOL (Adapt-AO) was implanted.IOL power was calculated by both SRK-T and Haigis formulas.The central macular thickness was measured by OCT preoperatively and postoperatively.The mean postoperative refractive prediction error (ME),mean absolute postoperative prediction error (MAE) and percentage of eyes achieved target refraction within ± 0.25,± 0.50 and ± 1.00 D were compared between the 2 groups.The correlation between the refractive error and macular thickness change was evaluated.Results The ME and MAE calculated by Haigis were (-0.47±0.66)D and (0.63±0.44)D in ARC+IMEM group,and (-0.18±0.74)D and (0.68±0.65)D in ARC group.The ME and MAE calculated by SRK-T were (-0.60 ±0.59) D and (0.73 ±0.41) D in ARC +IMEM group,and (-0.23 ±0.85)D and (0.75 ±0.69)D in ARC group.No significant differences were found between the two groups in each formula (all at P＞0.05).There was no significant difference of MAE distribution between the two groups in Haigis formula.In SRK-T formula,the percentage of MAE≤0.25 D in the ARC+IMEM group was significantly higher than that in the ARC group (x2 =7.114,P=0.007).In the A RC+IMEM group,the change of the macular thickness was (-97.4± 115.3)μm,which was statistically correlated with the ME of H aigis and SRK-T formulas (r=0.369,P =0.045;r =0.421,P =0.021).Conclusions There is a tendency toward myopia shift in patients underwent phacoemulsification and vitrectomy compared with conventional phacoemulsification.The myopia shift shows a significant correlation with macular thickness changes.Haigis formula performs better than SRK-T formula with the condition of un-optimized parameters.
ABSTRACT
Objective To classify idiopathic macular epiretinal membrane (IMEM) on the basis of OCT and its application value in predicting visual acuity of patients after operation.Methods Totally 29 patients (30 eyes) with IMEM admitted in Shenzhen Eye Hospital from February 2013 to May 2016 were included in this study and divided into 4 levels based on the morphologic change of macular fovea by preoperative OCT examination.All the patients were given minimally invasive vitrectomy for stripping macular epiretinal membrane (MEM),and examined for best corrected visual acuity (BCVA) and central foveal thickness (CFT) 6 months after surgery.Results As the grading increased,the patient's macular foveal became disorganized,the appearance of the macular membrane was presented and the loss of macular foveal was more obvious.There was significant difference between preoperative and postoperative LogMAR BCVA (all P ＜ 0.01).Preoperative and postoperative LogMAR BCVA was increased with the grading,and the difference was statistically significant (all P ＜ 0.05),suggesting that patients with high-level epiretinal membranes suffered from poor visual acuity.The difference between preoperative and postoperative LogMAR BCVA was the largest in patients with grade Ⅱ idiopathic macular degeneration,and the difference was statistically significant compared with other levels (all P ＜ 0.001).It is suggested that BCVA of grade Ⅱ patients has the greatest improvement after operation.Apart from grade Ⅲ patients,there was no significant difference in CFT among the patients with other levels before and after operation (all P ＞ 0.05).The preoperative and postoperative CFTs between patients were increased with the grading,and the differences were statistically significant (all P ＜ 0.001),suggesting that the higher the level was,the larger the macular thickness.Conclusion The classification of IMEM based on OCT examination images not only helps to predict the postoperative visual acuity and CFT recovery but also the timing of operation in patients with idiopathic macular degeneration.
ABSTRACT
·AIM: To investigate the relationship between the thickness of choroid and the development of idiopathic macular epiretinal membrane (IMEM). ·METHODS: A retrospective analysis on 48 cases (48 eyes) of idiopathic macular epiretinal membrane patients (the IMEM group) was taken in our hospital from January 2014 to December 2016, and 50 right eyes in 50 healthy persons with physical examination were selected the control group, comparison on subfoveal choroidal thickness (SFCT) levels of sicked eyes, normal eyes in IMEM group and the control group were made, postoperative SFCT level change of sicked eyes in IMEM patients and normal eyes were investigated via follow-up, and analysis on correlation between postoperative choroidal thickness and the best corrected visual acuity was taken. ·RESULTS: The SFCT of sicked eyes in IMEM group 362.22±40.75μm was significantly lower than that of the contralateral eyes (410.56 ± 38.45μ m) and the right eyes of the control group (420.73±39.63μ m), and data of the contralateral eyes was lower than right eyes of the control group, distinct difference was shown between groups(P<0.05). The IMEM group's SFCT of sicked eyes and normal eyes at postoperative 1wk had no significant difference with that before operation (P>0.05), and at postoperative 1mo,SFCT of sicked eyes and normal eyes evidently increased, showing sharp difference compared with that before operation (P<0. 05). After that, the SFCT value stabilized, but there was no obvious difference between the sicked eyes and healthy eyes at postoperatively 1mo (P>0.05). The numbers of patients whose postoperative BCVA ≥ 0. 5 with different preoperative SFCT values had statistically significant differences (P<0.05), and those with BCVA ≥0.5 of SFCT values> 380μ m were significantly higher than those with <320μ m and 320μ m-380μ m groups. Fisher exact probability analysis showed that the differences were significant. Pearson analysis showed that there was a positive correlation between the postoperative choroid thickness and the best corrected visual acuity of IMEM group (r=0.629,P<0.05). · CONCLUSION: Choroidal thinning may be an important cause of IMEM, and preoperative choroidal thickness also has an influential effect on postoperative visual recovery.
ABSTRACT
AIM:To explore the curative effect of 20G and 25G three-channel pars plana vitrectomy in the treatment of idiopathic macular epiretinal membrane,and to provide a theoretical basis for the minimally invasive treatment of idiopathic macular epiretinal membrane.METHODS:Medical records were retrospectively analyzed to explore curative effect.From January 2014 to December 2016,60 patients (60 eyes) with idiopathic macular pucker in our hospital for eye treatment were selected.They were grouped according to different operation way,in 28 patients (28 eyes) using three-channel 20G pars plana vitrectomy as the control group,32 patients (32 eyes) with 25G no-suture conjunctival vitrectomy as observation group.Two groups of patients were evaluated at 3mo after treatment for visual acuity,OCT examination,comfort,and we recorded the operation time,complications and recurrence.RESULTS:The operating time of observation group was 18-25min,average 20±2.15min,the control group was 22-35min,28 ± 2.07min on average,the difference was statistically significant (P＜0.05).At the time of the last follow-up,visual acuity of two groups improved compared with preoperative,without vision decrease.In observation group vision improved in 69％,significantly higher than that of control group (50％),difference was statistically significant (x2 =7.287,P＜ 0.05).Preoperative intraocular pressure of two groups was not significantly different.intraocular pressure of two group at postoperative 1d reduced compared with preoperative (Ftime =31.34,P＜0.01;Fgr.up =17.43,P＜0.01).There was no statistically significant difference at 7d and 1mo compared with preoperative (P＞0.05).Preoperative OCT on macular thickness of the two groups had no statistically significant difference.At 7d,1 and 3mo after treatment,epiretinal membranes disappeared in all patients,and the macular thickness reduced,the macular edema relieved (P＜ 0.05).At postoperative 3mo,two groups of patients were found no recurrence of epiretinal membranes.At 7d,1 and 3mo after treatment,differences between the two groups on macular thickness had no statistical significance.At postoperative 1d,in the control group there were foreign body sensation,swelling,and tears,pain and discomfort,20 patients with eye conjunctival congestion,edema,conjunctival suture to cause discomfort,the symptoms relieved after treatment.In observation group,12 patients with mild conjunctival congestion and edema,dotted hemorrhage at the wound in 4 eyes,5 eyes appeared lower intraocular pressure (6-8mmHg).without special treatment,Postoperative bleeding and edema stopped at 7d,intraocular pressure returned to normal.Patients of observation group did not have foreign body sensation,swelling and discomfort symptoms.At the time of the last follow-up,in the two groups,no iatrogenic retinal detachment,cataract,endophthalmitis and other serious complications occurred.CONCLUSION:The 20G of three-channel pars plana vitrectomy and 25G the no-suture conjunctival vitrectomy are equal for idiopathic macular epiretinal membrane,25G vitrectomy operation time is short with better patient comfort.
ABSTRACT
Objeetive To evaluate the morphological change in macuia in patients with idiopathic macuiar membrane and its relationship with visual acuity.Methods A retrospective study was conducted in 32 eye of 32 patients with idiopathic macuiar epiretinal membrane,who underwent the pars plana vitrectomy combined with internal membrane peeling.Then data on visual acuity and optical coherence variables,including the morphology and thickness of the fovea were collected and analyzed.Results Improvement in the best corrected visual acuity (BCVA) was observed in 29 patients,and the difference in the mean preoperative BCVA was statistically significant before surgery (0.25 ± 0.12) and after surgery (0.49 ± 0.28) (P ＜ 0.05).Unfortunately,3 patients maintained the same visual acuity after surgery.The thickness of the fovea decreased in all patients,from (385 ± 115) μm to (241 ± 64) μm (P ＜ 0.05).And the BCVA had a negative correlation with the thickness of the fovea.Conclusion The visual acuity of patients is closely related to the morphological feature of the macuia,and optical coherence tomography can be a useful tool for preoperative assessment and postoperative follow-up.
ABSTRACT
Objective To observe the prognosis and correlated factors of cystoid macular edema (CME) secondary to uveitis.Methods A retrospective,noncomparative case series study.The clinical data of 31 uveitis patients with CME were collected from Uveitis & Ocular Immunology Service of Tianjin Medical University Eye Hospital from August 2011 to December 2015.Pre-treatment and post-treatment data were collected,including details of best-corrected visual acuity (BCVA),central macular thickness (CMT),other macular complications,and intraocular pressure (IOP).Results Twenty-seven patients (36 eyes) were analyzed.At the 1 st month after treatment,complete resolution of CME was achieved in 14 eyes (38.9％),BCVA increased from (0.66 ±0.36) LogMAR at baseline to (0.40 ±0.31) LogMAR (P ＜0.001),and CMT decreased from (469.0 ± 99.1) μm at baseline to (368.7 ± 85.9) μm (P ＜ 0.001).At the 3rd month after treatment,complete resolution of CME was found in 19 eyes (52.8％),no significant difference was found in CMT(323.9 ±60.0) μm or BCVA(0.37 ±0.32)LogMAR compared with the 1 st month after treatment (P ＞ 0.05),significant difference was found in CMT(P ＜0.001) or BCVA(P ＜0.001) before the start of treatment.At the 6th month or more after treatment,complete resolution of CME occurred in 25 eyes (69.4％),BCVA(0.32 ± 0.28)LogMAR was significant difference compared with that before the start of treatment(P ＜ 0.05),at the 1st month(P ＜ 0.05),at the 3rd month (P ＜ 0.05).CMT (294.2 ± 81.2) μm was significant difference compared with that before the start of treatment(P ＜0.001),at the 1st month(P ＜0.001),however,no significant difference was compared with that at the 3rd month (P ＞ 0.05).At the 6th month or more after treatment,11 eyes (30.6％) had a persistent macular edema,complicated with macular epiretinal membrane,no significant correlation between the reduction of CMT(185.0 ± 114.2) μm and the improvement of BCVA (0.29 ± 0.21) LogMAR was found (r =0.322,P=0.052),while the improvement of BCVA(0.29 ± 0.21)LogMAR was negatively associated with the duration of CME(8.4 ±9.8)months(r =-0.395,P =0.015).Conclusion Current therapies are effective in curing most of the CME secondary to uveitis.The duration of CME,is correlated with poor final visual acuity,the presence of ERM is an important factor associated with regression of CME.
ABSTRACT
·AIM: To compare the treatment efficacy of vitrectomy with macular epiretinal membrane ( MEM ) peeling combined with or without air tamponade for idiopathic macular epiretinal membranes( IMEM) .·METHODS: Forty-two cases of IMEM patients ( 46 eyes ) associated with cataract were randomly divided into two groups. Twenty-five eyes of 23 cases in Group A were performed with vitrectomy with macular epiretinal membrane peeling combined with air tamponade. The other 21 eyes of 19 cases in Group B only underwent vitrectomy and macular epiretinal membrane peeling ( without air tamponade ) . The visual acuity and central macular thickness ( CMT ) were compared between the two groups before and after the surgery. The intraoperative and postoperative complications were also observed in both groups in the mean time.· RESULTS: There was no statistical significant difference between two groups in age, visual acuity and CMT before operation (P>0. 05). By 1wk, 3 and 6mo follow-up after operation, mean visual acuity improved significantly; mean CMT decreased obviously in both groups after the operation and the difference was statistically significant (P<0. 05). But for mean visual acuity and CMT, there were not statistically significant difference between two groups postoperatively at the same time(P>0. 05),there was no correlation between postoperative mean visual acuity and CMT in the two groups. No serious complications occurred during and after operation.· CONCLUSION: Vitrectomy with macular epiretinal membrane peeling can be a safe and effective treatment for IMEM, meanwhile air tamponade in vitreous cavity does not reveal more advantages in the treatment.
ABSTRACT
Epiretinal membrane (ERM) is a relatively common macular disease that forms along the surface of the internal limiting membrane (ILM) of the retina to some reason.The pathogenesis is not clear.Microincision vitrectomy surgery has been confirmed as a minimally invasive and very safe modality of treatment.Deciding when to perform a vitrectomy can be difficult.There are many factors which can affect the postoperative visual acuity,such as age,the thickness of macular,integrity of photoreceptor inner segment/outer segment (IS/OS) junction.
ABSTRACT
AIM: To evaluate the effects of 23G vs 20G pars plana vitrectomy ( PPV ) combined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation for macular epiretinal membrane with cataract. ·METHODS: Totally 45 eyes of 45 patients with macular epiretinal membrane and cataract were enrolled in this retrospective non-randomized controlled clinical study. All eyes were treated with PPV combined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation. There were 20 eyes in 23G PPV group, and 25 eyes in 20G PPV group. The best corrected visual acuity ( BCVA ) , intraocular pressure (IOP), counting of corneal endothelial cells ( CEC) and central retinal thickness ( CRT ) were examined before surgery. BCVA results were converted to the logarithm of the minimum angle of resolution ( LogMAR ) visual acuity. All operations were performed by the same doctor. Operation time for vitrectomy and membrane peeling, average ultrasound energy ( AVE) and effective phacoemulsification time ( EPT ) were recorded. BCVA and CRT were observed postoperatively at 30d and 90d, counting of CEC was observed postoperatively at 90d. IOP was observed postoperatively at 1d and 7d. ·RESULTS:The mean operation time for vitrectomy were 12. 57± 1. 35min in 23G group and 17. 30 ± 1. 19min in 20G group. The difference was statistically significant ( t =-12. 488, P<0. 01). There were no statistical significances in operation time for membrane peeling, AVE and EPT between 23G and 20G groups ( t=-0. 68,-1. 186,-0. 737, P=0. 500, 0. 242,0. 465). On 1d after surgery, IOP in 23G group was lower than that in 20G group, the difference was statistically significant (t= -2. 345, P=0. 024). The BCVA and CRT of the two groups both improved after operations. There were no statistically significant differences between two groups in terms of IOP, BCVA, and CRT ( F = 0. 465, 1. 895, 0. 689; P = 0. 499, 0. 176, 0. 411). IOP, BCVA and CRT were significant statistical different in different time-point within each group ( F=291. 245, 103. 06, 665. 402, P<0. 01 ). Different surgical methods of 23G and 20G had interactive effects on IOP with different time points ( F = 13. 245, P<0. 01 ), but different surgeries had no interactive effects on BCVA and CRT with different time points (F=1. 212, 2. 293;P=0. 283, 0. 129). The counting CEC in 23G group was more than that in 20G group postoperatively at 90d, the difference was statistically significant (t=2. 049, P=0. 048). ·CONCLUSION: The 23G PPV combined with internal limiting membrane peeling, phacoemulsification, intraocular lens implantation for macular epiretinal membrane with cataract is effective. Compared with 20G PPV, 23G PPV has advantages in operation time for vitrectomy and counting CEC. But lower IOP is likely in 23G PPV on 1d after surgery
ABSTRACT
Objective To investigate the correlation between retinal deformation degree and retina thickness (RT) detected by optic coherent tomography (OTC) in patients with idiopathic macular epiretinal membrane (IMEM). Methods The 66 eyes (56 patients) with IMEM diagnosed by OCT were retrospectively analyzed in this study. After best corrected visual acuity (BCVA), ocular fundus and OCT examination, patients were divided into three groups (mild, medium and severe) according to retinal deformation degrees. The RT value was measured manually. Results There were significant differences in RT values between mild, moderate and severe groups:(311.95 ±51.78) μm, (447.13±41.95) μm and (560.00± 58.23) μm (P<0.05). The values of BCVA were 0.78±0.16, 0.38±0.12 and 0.27±0.14 for mild, moderate and severe groups, there were significant differences between them (P<0.05). There was no significant correlation between RT and BCVA in mild group (r=-0.352,P=0.128). There was negative correlation between RT and BCVA in medium group and serious group (r=-0.768 and-0.482,P<0.05). Conclusion The retinal deformation degree and RT are two objective indicators to assess visual performance in patients of IMEM. When RT is more than 400 μm, it can be used as objective criteria for surgical intervention.