PREVALENCE AND RISK FACTORS OF ELLIPSOID ZONE DAMAGE AFTER PARS PLANA VITRECTOMY FOR IDIOPATHIC EPIRETINAL MEMBRANE,RETINA

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PREVALENCE AND RISK FACTORS OF ELLIPSOID ZONE DAMAGE AFTER PARS PLANA VITRECTOMY FOR IDIOPATHIC EPIRETINAL MEMBRANE
RETINA ( IF 3.3 ) Pub Date : 2022-02-01 , DOI: 10.1097/iae.0000000000003321
Michał Post _{1,

2} , Maria Vittoria Cicinelli _{3,

4} , Emma Clara Zanzottera ₁ , Alessandro Marchese _{1,

3,

4} , Francesco Bandello _{3,

4} , Michele Coppola ₁

Affiliation

Purpose:

To assess factors associated with external limiting membrane (ELM)/ellipsoid zone (EZ) damage after pars plana vitrectomy (PPV) for epiretinal membrane and evaluate ELM/EZ damage impact on functional and anatomical outcomes.

Methods:

Patients who underwent PPV with epiretinal membrane ± inner limiting membrane peeling were retrospectively analyzed. Best-corrected visual acuity and central macular thickness were longitudinally collected based on the available follow-up. Demographic data, clinical data, and surgical details were included in logistic regression models having ELM/EZ damage as a binary outcome.

Results:

Overall, 179 eyes (171 patients) were included; 93 had a 12-month follow-up. Thirty-four eyes (19%) had ELM/EZ damage after surgery; in nine eyes (5%), ELM/EZ damage persisted at 12 months. Phacoemulsification during PPV (odds ratio = 6.97; P = 0.007) and ELM/EZ damage before PPV (odds ratio = 6.91; P = 0.007) were risk factors for postoperative ELM/EZ disruption. Thicker outer nuclear layer (P = 0.002), thicker ectopic inner foveal layer (P < 0.001), and higher endoillumination power (P = 0.03) were associated with slower visual recovery. Inner limiting membrane peeling (P = 0.04) was associated with slower anatomical recovery.

Conclusion:

Cataract extraction and outer retinal damage before PPV are associated with higher risk of photoreceptor damage postoperatively. The rate of visual improvement varies as a function of retinal layers' distortion before surgery; additional retinal manipulation slows restoration of the macular anatomy.

中文翻译：

特发性视网膜前膜平坦部玻璃体切除术后椭圆体区损伤的患病率和危险因素

目的：

评估与视网膜前膜平坦部玻璃体切除术 (PPV) 后外界膜 (ELM)/椭圆体区 (EZ) 损伤相关的因素，并评估 ELM/EZ 损伤对功能和解剖结果的影响。

方法：

回顾性分析了接受 PPV 与视网膜前膜±内界膜剥离的患者。根据可用的随访结果纵向收集最佳矫正视力和中央黄斑厚度。将 ELM/EZ 损伤作为二元结果的逻辑回归模型包括人口统计学数据、临床数据和手术细节。

结果：

总体而言，包括 179 只眼（171 名患者）；93 人进行了 12 个月的随访。34 只眼 (19%) 术后出现 ELM/EZ 损伤；在 9 只眼睛 (5%) 中，ELM/EZ 损伤持续 12 个月。PPV 期间的超声乳化（优势比 = 6.97；P = 0.007）和 PPV 之前的 ELM/EZ 损伤（优势比 = 6.91；P = 0.007）是术后 ELM/EZ 破坏的危险因素。较厚的外核层 ( P = 0.002)、较厚的异位内凹层 ( P < 0.001) 和较高的内照明功率 ( P = 0.03) 与视力恢复较慢有关。内界膜剥离（P = 0.04）与较慢的解剖恢复有关。