IDENTIFICATION OF FACTORS RELATED TO SUBFOVEAL DETACHMENT SECONDARY TO EPIRETINAL MEMBRANE.
IDENTIFICATION OF FACTORS RELATED TO SUBFOVEAL DETACHMENT SECONDARY TO EPIRETINAL MEMBRANE.
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与视网膜前膜继发的凹下脱离相关的因素的识别。
DOI：
10.1097/iae.0000000000002056
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Freeman,WilliamR
中科院分区：
文献类型：
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作者：
Muftuoglu,IlkayKilic;Lin,Tiezhu;Nudleman,Eric;Gaber,Raouf;Bartsch,Dirk-Uwe;Freeman,WilliamR
目的：探讨继发于视网膜前膜(ERM)的黄斑下黄斑下脱离(SD)的相关因素，以及膜剥离后SD转归的预测因素。方法：对行玻璃体切割术治疗特发性ERM剥离的患者进行回顾性分析。对术前眼球中心凹厚度、中心凹中心点厚度、视网膜内囊肿的存在、膜的连续性、中心凹内膜面积(1 Mm)和整个黄斑(6 Mm)的光谱域光学相干断层扫描特征进行评估，以找到预测SD存在的最佳指标。结果：158只眼中，SD的发生率为20.2%(32只眼)，SD的发生与黄斑内膜的受累密切相关。术后90.6%(29眼)SD完全消退，中位时间2.97个月(0.03~12.0个月)。黄斑中心凹内膜面积是预测SD消失时间的唯一有意义的指标(危险比=1.2，95%可信区间=1.100-1.324，P=0.021)。一小部分眼睛表现出进一步的变化，包括液体的波动(6.2%)或持续(3.1%)。结论：黄斑上的ERM范围越大，SD发生的可能性越大。除黄斑中心凹1,000μm以内的膜范围外，黄斑下脱离消失的时间似乎不受术前和围手术期因素的影响。
Purpose:To demonstrate factors related to the presence of subfoveal detachment (SD) secondary to epiretinal membrane (ERM) and to characterize the predictors for the resolution of SD after membrane peeling.Methods:A retrospective chart review was conducted for the patients who underwent pars plana vitrectomy for the idiopathic ERM peeling. Preoperative spectral domain optical coherence tomography characteristics of the eyes including central foveal thickness, foveal center point thickness, presence of intraretinal cyst, continuity of the membrane, area of the membrane within fovea (1 mm), and entire macula (6 mm) were evaluated to find the best predictors for the presence of SD. These predictors as well as perioperative parameters including use of internal tamponade and volume of SD were considered for time of resolution of SD.Results:Of 158 included eyes, 20.2% eyes (32 eyes) had SD, and the presence of SD was significantly related to involvement of the membrane within the macula. After surgery, SD completely resolved in 90.6% of eyes (29 eyes) at a median of 2.97 months (range: 0.03–12.0 months). The area of the membrane within fovea was the only significant predictor for time to resolution of SD (hazard ratio= 1.20, 95% confidence interval= 1.100–1.324, P= 0.021). A small percent of eyes showed some further changes including fluctuation (6.2%) or persistence (3.1%) of fluid.Conclusion:A larger extension of ERM over the macula is related to higher likelihood of the presence of SD. Time for resolution of subfoveal detachment does not seem to be affected by the preoperative and perioperative factors except the extent of membrane within 1,000 μm of the fovea.