特发性黄斑前膜术后视力与黄斑区形态结构和血流密度的相关性

Correlation between postoperative visual acuity and macular morphological structure and blood flow density in patients with idiopathic macular epiretinal membrane

摘要:

目的：利用光学相干断层扫描血管成像(OCTA)观察特发性黄斑前膜(IMEM)患者术后黄斑区形态结构及血流密度的变化，分析其与视力的相关性。方法：前瞻性研究。连续收集2020-01/2021-07就诊于我院的IMEM患者45例45眼，观察术前、术后1wk，1、3、6mo最佳矫正视力(BCVA)、中央黄斑区厚度(CMT)、中心凹无血管区(FAZ)面积、中心凹视网膜浅层毛细血管丛(SCP)血流密度的变化。结果：与术前比较，纳入患者术后1wk BCVA无明显变化(P>0.05)，术后1、3、6mo均明显改善(P<0.05)； 术后1wk CMT明显增厚(P<0.05)，术后1、3、6mo均明显降低(P<0.05)； 术后1wk，1mo FAZ面积无明显变化(P>0.05)，术后3、6mo明显扩大(P<0.05)； 术后1wk，1、3mo SCP血流密度均无明显变化(P>0.05)，术后6mo明显减少(P<0.05)。术后3、6mo纳入患者BCVA与CMT呈正相关(r=0.457、0.615，P=0.032、0.012)。结论：特发性黄斑前膜手术后1mo内视力恢复快，之后趋于平稳，而中心凹形态及血流分布的恢复滞后于视力恢复，且与视力无明显相关性。

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.