特发性黄斑前膜患者视网膜和脉络膜厚度分析:基于扫频源OCT

Analysis of retinal and choroidal thicknesses in patients with idiopathic macular epiretinal membrane:based on swept source optical coherence tomography

目的采用扫频源OCT(SS-OCT)研究特发性黄斑前膜(IMEM)患者视网膜和脉络膜厚度特点。方法横断面研究。纳入2019年3月至2020年12月就诊于郑州大学第一附属医院的IMEM患者60例60眼为试验组,另纳入36例60眼正常眼为对照组。使用SS-OCT测量并分析受检者黄斑中心凹下视网膜厚度(SFRT)、黄斑中心凹下脉络膜厚度(SFCT)及过黄斑中心凹直径分别为1 mm圆形(中心区)及直径>1~3 mm(内环)、>3~6 mm(外环)同心环内上侧、下侧、鼻侧、颞侧共9个区域的黄斑区平均视网膜厚度(AMRT)、黄斑区平均脉络膜厚度(AMCT)。对试验组患眼按Gass分期分为不同亚组,行亚组间SFRT、SFCT及各区域AMRT、AMCT的分析。结果SFRT与各区域的AMRT试验组IMEM患眼均大于对照组入选眼,差异均有统计学意义(均为P<0.05)。与对照组相比,试验组IMEM患眼除外环颞侧AMCT更薄外,其余8个区域AMCT及SFCT两组间差异均无统计学意义(均为P>0.05)。试验组中,Gass I期、Gass II期IMEM患眼各有8个区域的AMCT及SFCT较Gass 0期厚,差异均有统计学意义(均为P<0.05)。试验组IMEM患眼Gass分期与SFCT、中心区AMCT、内环下侧AMCT、内环鼻侧AMCT、内环颞侧AMCT、外环下侧AMCT、外环鼻侧AMCT均呈显著正相关(均为P<0.05)。结论黄斑前膜可能是IMEM患眼脉络膜厚度的影响因素,IMEM的分期或严重程度与脉络膜厚度呈正相关,但IMEM患眼仅外环颞侧AMCT与正常对照眼表现出了统计学上的差异性。

Objective To explore the features of retinal and choroidal thickness in patients with idiopathic macular epiretinal membrane(IMEM)using swept source optical coherence tomography(SS-OCT).Methods A cross-sectional study.Sixty eyes of 60 patients with idiopathic epiretinal membrane admitted to the First Affiliated Hospital of Zhengzhou University from March 2019 to December 2020 were included as the experimental group,and another 60 eyes of 36 normal individuals were collected as the control group.SS-OCT was used to detect and analyze the subfoveal retina thickness(SFRT),subfoveal choroidal thickness(SFCT)and the average macular retina thickness(AMRT),average macular choroidal thickness(AMCT)of 9 map fields surrounded by the superior,inferior,nasal and temporal regions in the concentric circles with diameters of 1 mm(central area),>1-3 mm(inner ring),>3-6 mm(outer ring).The experimental group was divided into different subgroups according to Gass staging,and intra-subgroup analysis of SFRT,SFCT and the AMRT,AMCT in all regions were conducted.Results The SFRT and AMRT in all regions of the experimental group were significantly thicker than those in the control group(all P<0.05).AMCT in the temporal outer ring field was significantly thinner in the experimental group than that in the control group(P<0.05),and there were no differences of SFCT and AMCT in other 8 regions between two groups(all P>0.05).In the experimental group,the SFCT and the AMCT in the 8 areas were significantly thicker in Gass I stage and Gass II stage than those in Gass 0 stage(all P<0.05).Gass staging in the experimental group was positively correlated with SFCT and the AMCT in the central area,the inferior,nasal and temporal areas of the inner ring,the inferior and nasal areas of the outer ring,with statistical differences(all P<0.05).Conclusion The presence of macular epiretinal membrane may be an impact factor of choroidal thickness in IMEM eyes.The choroidal thickness in IMEM eyes were positively associated with the stage or severity of IMEM.However,only AMCT in the temporal outer ring significantly differs from that in the normal control eyes.