光学相干断层扫描成像在特发性视网膜前膜中的应用研究

doi:10.6040/j.issn.1673-3770.0.2022.531

摘要/Abstract

摘要： 特发性视网膜前膜(idiopathic epiretinal membrane, iERM)是一种病因未明的可引起视觉质量下降的眼科疾病,可通过持续牵拉使视网膜出现复杂多样的改变。光学相干断层扫描成像(optical coherence tomography, OCT)能够清晰显示iERM引起的视网膜特征性改变。在视网膜内层,不同形态的特发性视网膜前膜可产生不同的视力预后;异位中心凹内层的出现是视力下降的危险因素;内核层增厚可导致视物变形,而视网膜囊性腔隙可能与Müller细胞损伤有关。在视网膜外层,椭圆体带、嵌合体带以及棉球征可评估感光细胞受损程度。论文就近年来iERM患者的OCT特征性改变进行综述。

关键词: 特发性视网膜前膜, 光学相干断层扫描成像, 椭圆体带, 异位中心凹内层

Abstract: Idiopathic epiretinal membrane(iERM)is a medically unexplained ophthalmic disease that can cause a decline in vision quality due to complex and diverse changes in the retina through continuous vitreomacular traction. Optical coherence tomography(OCT)can clearly display the characteristic changes to the retina caused by iERM. In the inner retina, different forms of iERM can produce different visual prognoses. For example, the appearance of ectopic inner foveal layers is a risk factor for vision loss, thickening of the inner nuclear layer can cause visual distortion, and intraretinal cystic spaces may be related to injured Müller cells. In the outer retina, the integrity of the ellipsoid zone, interdigitation zone, and the cotton ball sign can indicate the degree of photoreceptor damage. This article reviews the characteristic changes visible on OCT in patients with iERM.

Key words: Idiopathic epiretinal membrane, Optical coherence tomography, Ellipsoid zone, Ectopic inner foveal layers

中图分类号:

R774.5

刘江川,李鹏伟,郭建强,陆慧琴. 光学相干断层扫描成像在特发性视网膜前膜中的应用研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(1): 138-142.

LIU Jiangchuan, LI Pengwei, GUO Jianqiang, LU Huiqin. Application of optical coherence tomography in idiopathic epiretinal membrane[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(1): 138-142.

参考文献

[1] Chua PY, Sandinha MT, Steel DH. Idiopathic epiretinal membrane: progression and timing of surgery[J]. Eye(Lond), 2022, 36(3): 495-503. doi:10.1038/s41433-021-01681-0
[2] Duker JS, Kaiser PK, Binder S, et al. The international vitreomacular traction study group classification of vitreomacular adhesion, traction, and macular hole[J]. Ophthalmology, 2013, 120(12): 2611-2619. doi:10.1016/j.ophtha.2013.07.042
[3] Fung AT, Galvin J, Tran T. Epiretinal membrane: a review[J]. Clin Exp Ophthalmol, 2021, 49(3): 289-308. doi:10.1111/ceo.13914
[4] Byon IS, Pak GY, Kwon HJ, et al. Natural history of idiopathic epiretinal membrane in eyes with good vision assessed by spectral-domain optical coherence tomography[J]. Ophthalmologica, 2015, 234(2): 91-100. doi:10.1159/000437058
[5] 林晓芹, 吴苗琴. 特发性视网膜前膜的发病机制及治疗进展[J]. 山东大学耳鼻喉眼学报, 2020, 34(2): 121-128. doi:10.6040/j.issn.1673-3770.0.2019.499 LIN Xiaoqin, WU Miaoqin. Pathogenesis and treatment of idiopathic epiretinal membranes[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(2): 121-128. doi:10.6040/j.issn.1673-3770.0.2019.499
[6] Konidaris V, Androudi S, Alexandridis A, et al. Optical coherence tomography-guided classification of epiretinal membranes[J]. Int Ophthalmol, 2015, 35(4): 495-501. doi:10.1007/s10792-014-9975-z
[7] Taniguchi H, Yoshida I, Sakamoto M, et al. Epiretinal membrane appearance or progression after intravitreal injection in age-related macular degeneration[J]. BMC Ophthalmol, 2021, 21(1): 190. doi:10.1186/s12886-021-01944-0
[8] Govetto A, Lalane RA, Sarraf D, et al. Insights into epiretinal membranes: presence of ectopic inner foveal layers and a new optical coherence tomography staging scheme[J]. Am J Ophthalmol, 2017, 175: 99-113. doi:10.1016/j.ajo.2016.12.006
[9] González-Saldivar G, Berger A, Wong D, et al. Ectopic inner foveal layer classification scheme predicts visual outcomes after epiretinal membrane surgery[J]. Retina, 2020, 40(4): 710-717. doi:10.1097/IAE.0000000000002486
[10] Govetto A, Virgili G, Rodriguez FJ, et al. Functional and anatomical significance of the ectopic inner foveal layers in eyes with idiopathic epiretinal membranes: surgical results at 12 months[J]. Retina, 2019, 39(2): 347-357. doi:10.1097/IAE.0000000000001940
[11] Doguizi S, Sekeroglu MA, Ozkoyuncu D, et al. Clinical significance of ectopic inner foveal layers in patients with idiopathic epiretinal membranes[J]. Eye(Lond), 2018, 32(10): 1652-1660. doi:10.1038/s41433-018-0153-9
[12] Govetto A, Su D, Farajzadeh M, et al. Microcystoid macular changes in association with idiopathic epiretinal membranes in eyes with and without Glaucoma: clinical insights[J]. Am J Ophthalmol, 2017, 181: 156-165. doi:10.1016/j.ajo.2017.06.023
[13] Baek J, Park HY, Lee JH, et al. Elevated M2 macrophage markers in epiretinal membranes with ectopic inner foveal layers[J]. Invest Ophthalmol Vis Sci, 2020, 61(2): 19. doi:10.1167/iovs.61.2.19
[14] Bressler NM, Edwards AR, Antoszyk AN, et al. Retinal thickness on Stratus optical coherence tomography in people with diabetes and minimal or no diabetic retinopathy[J]. Am J Ophthalmol, 2008, 145(5): 894-901. doi:10.1016/j.ajo.2007.12.025
[15] Chalam KV, Bressler SB, Edwards AR, et al. Retinal thickness in people with diabetes and minimal or no diabetic retinopathy: Heidelberg Spectralis optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2012, 53(13): 8154-8161. doi:10.1167/iovs.12-10290
[16] Kang HM, Koh HJ, Lee SC. Visual outcome and prognostic factors after surgery for a secondary epiretinal membrane associated with branch retinal vein occlusion[J]. Graefes Arch Clin Exp Ophthalmol, 2015, 253(4): 543-550. doi:10.1007/s00417-014-2731-2
[17] Okamoto F, Sugiura Y, Okamoto Y, et al. Inner nuclear layer thickness as a prognostic factor for Metamorphopsia after epiretinal membrane surgery[J]. Retina, 2015, 35(10): 2107-2114. doi:10.1097/iae.0000000000000602
[18] Ichikawa Y, Imamura Y, Ishida M. Inner nuclear layer thickness, a biomarker of Metamorphopsia in epiretinal membrane, correlates with tangential retinal displacement[J]. Am J Ophthalmol, 2018, 193: 20-27. doi:10.1016/j.ajo.2018.06.001
[19] Labin AM, Safuri SK, Ribak EN, et al. Müller cells separate between wavelengths to improve day vision with minimal effect upon night vision[J]. Nat Commun, 2014, 5: 4319. doi:10.1038/ncomms5319
[20] 李鹏伟, 苏光明, 刘江川, 等. 光学相干断层扫描血管成像在2型黄斑毛细血管扩张症中的应用进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 140-144. doi: 10.6040/j.issn.1673-3770.0.2021.45 LI Pengwei, SU Guangming, LIU Jiangchuan, et al. Application of optical coherence tomography angiography in macular telangiectasia type 2[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(1): 140-144. doi: 10.6040/j.issn.1673-3770.0.2021.45
[21] Shiode Y, Morizane Y, Toshima S, et al. Surgical outcome of idiopathic epiretinal membranes with intraretinal cystic spaces[J]. PLoS One, 2016, 11(12): e0168555. doi:10.1371/journal.pone.0168555
[22] Güler M, Urfalıo glu S, Damar Güngör E, et al. Clinical and optical coherence tomography analysis of intraretinal microcysts in patients with epiretinal membrane[J]. Semin Ophthalmol, 2021, 36(8): 787-793. doi:10.1080/08820538.2021.1906915
[23] Cobos E, Arias L, Ruiz-Moreno J, et al. Preoperative study of the inner segment/outer segment junction of photoreceptors by spectral-domain optical coherence tomography as a prognostic factor in patients with epiretinal membranes[J]. Clin Ophthalmol, 2013, 7: 1467-1470. doi:10.2147/OPTH.S44837
[24] Spaide RF, Curcio CA. Anatomical correlates to the bands seen in the outer retina by optical coherence tomography: literature review and model[J]. Retina, 2011, 31(8): 1609-1619. doi:10.1097/IAE.0b013e3182247535
[25] Fernández EJ, Hermann B, Povazay B, et al. Ultrahigh resolution optical coherence tomography and pancorrection for cellular imaging of the living human retina[J]. Opt Express, 2008, 16(15): 11083-11094. doi:10.1364/oe.16.011083
[26] Shimozono M, Oishi A, Hata M, et al. The significance of cone outer segment tips as a prognostic factor in epiretinal membrane surgery[J]. Am J Ophthalmol, 2012, 153(4): 698-704.e1. doi:10.1016/j.ajo.2011.09.011
[27] Watanabe K, Tsunoda K, Mizuno Y, et al. Outer retinal morphology and visual function in patients with idiopathic epiretinal membrane[J]. JAMA Ophthalmol, 2013, 131(2): 172-177. doi:10.1001/jamaophthalmol.2013.686
[28] Stevenson W, Prospero Ponce CM, Agarwal DR, et al. Epiretinal membrane: optical coherence tomography-based diagnosis and classification[J]. Clin Ophthalmol, 2016, 10: 527-534. doi:10.2147/OPTH.S97722
[29] Fernandes TF, Sousa K, Azevedo I, et al. Baseline visual acuity and interdigitation zone as predictors in idiopathic epiretinal membranes: a retrospective cohort study[J]. Eur J Ophthalmol, 2021, 31(3): 1291-1298. doi:10.1177/1120672120932094
[30] Li DQ, Rudkin AK, Altomare F, et al. Predicting progression of untreated macular pucker using retinal surface en face optical coherence tomography[J]. Ophthalmologica, 2020, 243(5): 323-333. doi:10.1159/000497490
[31] Tsunoda K, Watanabe K, Akiyama K, et al. Highly reflective foveal region in optical coherence tomography in eyes with vitreomacular traction or epiretinal membrane[J]. Ophthalmology, 2012, 119(3): 581-587. doi:10.1016/j.ophtha.2011.08.026
[32] Govetto A, Bhavsar KV, Virgili G, et al. Tractional abnormalities of the central foveal bouquet in epiretinal membranes: clinical spectrum and pathophysiological perspectives[J]. Am J Ophthalmol, 2017, 184: 167-180. doi:10.1016/j.ajo.2017.10.011
[33] Brinkmann MP, Michels S, Brinkmann C, et al. Epiretinal membrane surgery outcome in eyes with abnormalities of the central bouquet[J]. Int J Retina Vitreous, 2021, 7(1): 7. doi:10.1186/s40942-020-00279-0
[34] Spaide RF. Closure of an outer lamellar macular hole by vitrectomy: hypothesis for one mechanism of macular hole formation[J]. Retina, 2000, 20(6): 587-590. doi:10.1097/00006982-200006000-00001
[35] Bringmann A, Unterlauft JD, Wiedemann R, et al. Two different populations of Müller cells stabilize the structure of the fovea: an optical coherence tomography study[J]. Int Ophthalmol, 2020, 40(11): 2931-2948. doi:10.1007/s10792-020-01477-3

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed