OLINiOAL AND MoRpHoLoGiOAL outcomes AND BENEFiT oF EARLY iDiopATHiO EpiRETiNAL MEMBRANES SURGERY
| Autor: | A.V. Miridonova, A.I. Kolesnik, V.I. Shestopalov, V.D. Zakharov, D.S. Ostrovsky, S.A. Borzenok, I.M. Gorshkov, S.V. Kolesnik |
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| Rok vydání: | 2019 |
| Předmět: | |
| Zdroj: | Aspirantskiy Vestnik Povolzhiya. 19:70-79 |
| ISSN: | 2410-3764 2072-2354 |
| Popis: | Surgical treatment of iERM improves or stabilizes visual acuity (VA), decreases metamorphopsia, and restores macular anatomy. Nevertheless patients with low preoperative VA do not enjoy complete recovery after membrane removal. Limited restoration of the VA in these patients can be due to chronic traction of retina, vascular leakage and persistent cystoid macular edema. All these factors restrict the restoration of macular anatomy and function. Objective. The purpose is to investigate the functional, structural and morphological outcomes of iERM surgical treatment in different proliferation phase. Materials and methods. 60 patients were divided into 3 groups: 1 group - patients with VA 0.7-0.9; 2 group - patients with VA 0.3-0.6; 3 group with VA 0.1-0.3. Idiopathic ERM/ILM samples from vitrectomy were analyzed for glial acidic fibrillary protein (GFAP), cellular retinaldehyde-binding protein (CRALBP), a-SMA, vimentin, CD65 and type II, IV, VI collagen using flat-mount immunohistochemistry. Results. We observed transdifferentiated retinal Muller cells and astrocytes in myofibroblast-like phenotype which induced tissue contraction. In the course of time membranes demonstrated rough extratrecellular matrix component combination. These membranes had strong adhesion to ILM and were removed in the unique block during vitrectomy. An improvement of postoperative best-corrected visual acuity (BCVA), as well as a decrement in central foveal thickness (CFT) was observed in all groups, maximum after 1 year of observation. Postoperative BCVA was better in patients with satisfactory preoperative VA. Comparative analysis of the three groups showed a significant improvement in BCVA and CFT in the first group. These patients have very little macular damage resulting in good recovery of the macular function. Conclusions. We conclude that vitrectomy for early symptomatic iERM is beneficial in preserving excellent vision. Early intervention may prevent the evolvement of non-reversible damage to the outer retina. It is a safe procedure associated with a lower chance of surgical difficulty during ERM/ILM peeling. |
| Databáze: | OpenAIRE |
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