Changes of foveal avascular zone size and correlation between foveal avascular zone size and metamorphopsia before and after idiopathic macular epiretinal membrane surgery

Q4 Medicine

中华眼底病杂志 Pub Date : 2020-03-25 DOI:10.3760/CMA.J.CN511434-20181213-00426

M. Zeng, Xiao Chen, Chunyan C Cai, Ling Hong, Qin Ding, Ying Yan

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引用次数: 0

Abstract

Objective To observe the changes of foveal avascular zone (FAZ) size before and after surgery in idiopathic macular epiretinal membrane (IMEM) eyes and analyze the correlation of FAZ with metamorphopsia. Methods A retrospective case series study. From August 2016 to October 2017, 42 eyes of 38 patients affected with IMEM diagnosed in Central Theater Command General Hospital of Chinese People's Liberation Army were enrolled in this study. All the patients underwent a 25G pars plana vitrectomy (PPV) with IMEM removal and ininternal limiting membrane (ILM) peeling. The BCVA was measured using the international standard visual acuity chart, and the results were converted to the logMAR visual acuity. The severity of metamorphopsia was measured using M-charts. The FAZ areas were evaluated with OCT angiography in both the superficial and deep capillary plexus layers. The central macular thickness (CMT) were assessed with spectral-domain OCT before and after surgery. The logMAR BCVA was 0.61±0.21. The M-score was 0.66±0.38. The CMT of fovea was 337.71±57.63 μm. The FAZ areas in superficial and deep capillary plexus were 0.113±0.037 mm2 and 0.202±0.03 mm2, respectively. The differences in BCVA, M-score and FAZ area before and 1, 3, 6, 12 months after surgery were analyzed by ANOVA. The Spearman rank correlation analysis was performed to investigate the relationship between FAZ areas, visual acuity and metamorphopsia. Results At 12 month after surgery, the FAZ areas in superficial and deep capillary plexus were 0.146±0.021 mm2 and 0.240±0.019 mm2, respectively. Compared with baseline, the the FAZ areas in superficial and deep capillary plexus after surgery significantly increased (F=8.484, 14.346; P<0.001,<0.001). The postoperative logMAR BCVA 0.47±0.19, M-score 0.12±0.22 and CMT 270.60±33.27 μm were significantly improved compared with baseline (F=5.044, 17.763, 13.545; P=0.001, <0.001, <0.001). The preoperative FAZ area in superficial capillary plexus correlated negatively with preoperative M-score (r=-0.816, P<0.001); the preoperative FAZ area in deep capillary plexus correlated negatively with preoperative BCVA and M-score (r=-0.422, -0.882; P=0.005,<0.001). The postoperative FAZ area in superficial capillary plexus correlated negatively with preoperative and postoperative M-score (r=-0.791,-0.716; P<0.001,<0.001). The postoperative FAZ area in deep capillary plexus correlated negatively with BCVA and preoperative and postoperative M-score (r=-0.343, -0.330, -0.732, -0.694; P=0.026, 0.033,<0.001,<0.001). Conclusions PPV with ILM peeling can effectively restore the FAZ areas in superficial and deep capillary plexus, improve the visual acuity and metamorphopsia in patients with IMEM. Both superficial and deep plexus FAZ areas correlated negatively with metamorphopsia, and deep plexus FAZ area also correlated negatively with BCVA. Key words: Macula lutea; Membranes; Vitrectomy; Tomographyoptical coherence; Foveal avascular zone; Metamorphopsia

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特发性黄斑视网膜前膜手术前后中央凹无血管区大小的变化及与变形的关系

目的观察特发性黄斑视网膜前膜(IMEM)眼手术前后中央凹无血管带(FAZ)大小的变化，并分析FAZ与变形的相关性。方法回顾性病例系列研究。本研究选取2016年8月至2017年10月在中国人民解放军中央战区总医院诊断的38例IMEM患者的42只眼作为研究对象。所有患者均行25G玻璃体切割术(PPV)，同时切除IMEM和剥离内限制膜(ILM)。采用国际标准视力表测量BCVA，并将测量结果转换为logMAR视力。用m图测量变形的严重程度。应用OCT血管造影对浅层和深层毛细血管丛的FAZ区域进行评估。术前、术后用光谱域OCT评估中央黄斑厚度(CMT)。logMAR BCVA为0.61±0.21。m -评分为0.66±0.38。中央窝CMT为337.71±57.63 μm。浅、深毛细血管丛FAZ面积分别为0.113±0.037 mm2和0.202±0.03 mm2。采用方差分析分析术前、术后1、3、6、12个月BCVA、M-score、FAZ面积的差异。采用Spearman秩相关分析探讨FAZ面积、视力与变形的关系。结果术后12个月，浅、深毛细血管丛FAZ面积分别为0.146±0.021 mm2和0.240±0.019 mm2。与基线比较，术后浅、深毛细血管丛FAZ面积显著增加(F=8.484, 14.346;P < 0.001, < 0.001)。术后logMAR BCVA 0.47±0.19,M-score 0.12±0.22,CMT 270.60±33.27 μm较基线显著改善(F=5.044, 17.763, 13.545;P=0.001， <0.001， <0.001)。术前浅毛细血管丛FAZ面积与术前M-score呈负相关(r=-0.816, P<0.001);术前深毛细血管丛FAZ面积与术前BCVA、M-score呈负相关(r=-0.422， -0.882);P = 0.005 < 0.001)。术后浅毛细血管丛FAZ面积与术前、术后M-score呈负相关(r=-0.791，-0.716;P < 0.001, < 0.001)。术后深毛细血管丛FAZ面积与BCVA、术前术后M-score呈负相关(r=-0.343， -0.330， -0.732， -0.694;P = 0.026、0.033 < 0.001,< 0.001)。结论PPV + ILM剥离能有效恢复浅、深毛细血管丛FAZ区，改善IMEM患者的视力和变形。浅丛、深丛FAZ面积与变形畸形呈负相关，深丛FAZ面积与BCVA呈负相关。关键词:黄斑;膜;玻璃体切除术;Tomographyoptical一致性;中央凹无血管区;视

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来源期刊

中华眼底病杂志 Medicine-Ophthalmology

CiteScore

0.40

自引率

0.00%

发文量

5383

期刊介绍： Chinese Journal of Ocular Fundus Diseases is the only scientific journal in my country that focuses on reporting fundus diseases. Its purpose is to combine clinical and basic research, and to give equal importance to improvement and popularization. It comprehensively reflects the leading clinical and basic research results of fundus disease disciplines in my country; cultivates professional talents in fundus disease, promotes the development of fundus disease disciplines in my country; and promotes academic exchanges on fundus disease at home and abroad. The coverage includes clinical and basic research results of posterior segment diseases such as retina, uveal tract, vitreous body, visual pathway, and internal eye diseases related to systemic diseases. The readers are medical workers and researchers related to clinical and basic research of fundus diseases. According to the journal retrieval report of the Chinese Institute of Scientific and Technological Information, the comprehensive ranking impact factor and total citation frequency of the Chinese Journal of Ocular Fundus Diseases have been among the best in the disciplines of ophthalmology, otolaryngology, and ophthalmology in my country for many years. The papers published have been included in many important databases at home and abroad, such as Scopus, Peking University Core, and China Science Citation Database (CSCD).