玻璃体切割联合黄斑前膜及内界膜剥除术后患者黄斑中心凹视网膜厚度、无血管区面积及微血管密度的变化

目的 应用光学相干断层扫描血管成像(OCTA)探讨玻璃体切割联合黄斑前膜及内界膜剥除术后患者黄斑中心凹视网膜厚度(CMT)、黄斑中心凹无血管区(FAZ)面积及黄斑中心凹与旁中心凹浅层、深层视网膜微血管密度的变化.方法 本研究为前瞻性病例分析,选取2018年11月至2019年11月于我院就诊且经OCT确诊的黄斑前膜患者2...

Changes in macular thickness,foveal avascular zone area,and vessel density after vitrectomy with epiretinal membrane and internal limiting membrane

Objective To investigate the preoperative and postoperative central macular thickness(CMT),foveal avascular zone(FAZ)area,and microvessel density in the superficial and deep layers of the macular fovea and parafovea among patients with idiopathic macular epiretinal membrane after vitrectomy with epiretinal membrane and internal limiting membrane peeling using optical coherence tomography angiography(OCTA).Methods This was a prospective observational case series of 26 eyes of 26 patients who were diagnosed as idiopathic macular epiretinal membrane by optical coherence tomography(OCT)from November 2018 to November 2019.All patients underwent conventional 23G three-incision closed vitrectomy with epiretinal membrane and internal limiting membrane peeling.Best-corrected visual acuity(BCVA),CMT,FAZ area,as well as superficial capillary plexus(SCP)density and deep capillary plexus(DCP)density in the foveal and parafoveal region were evaluated and analyze statistically.Results Compared with preoperative data(0.69±0.28)logMAR,BCVA were(0.51±0.40)logMAR,(0.48±0.37)logMAR,(0.42±0.89)logMAR,(0.43±0.38)logMAR,and(0.37±0.37)logMAR,respectively 3 days,1 week,1 month,3 months and 6 months after operation,and postoperative BCVA significantly improved compared with preoperative data(all P<0.01).Compared with preoperative data(458.67±82.13)μm,CMT were(401.04±63.53)μm,(408.49±58.94)μm,(406.67±63.75)μm,(378.80±38.93)μm,and(384.72±37.11)μm 3 days,1 week,1 month,3 months and 6 months after operation,respectively,and postoperative CMT was dramatically decreased(all P<0.01).Compared with the preoperative data,no significant differences were statistical in the FAZ area at all time-points after operation(all P>0.05).The deep capillary plexus density in the foveal significantly increased from(37.52±8.34)%before operation into(44.78±8.31)%in idiopathic macular epiretinal membrane eyes at 3 days after surgery(P<0.05),whereas no significant differences were found in the superficial and the deep vessel density of foveal and parafoveal region in other time points(all P>0.05).Conclusion OCTA provides a better tool to evaluate the surgical prognosis of patients with idiopathic macular epiretinal membrane after vitrectomy with epiretinal membrane and internal limiting membrane peeling.Visual functional recovery might be faster than the rebuild of macular architecture and the circulation of retinal vascular network after surgery.