Abstract：Objective This study aims to explore the application value of the optical coherence tomography (OCTA) in observing the changes in the central macular thickness (CMT) and the retinal blood flow in patients with idiopathic macular epiretinal membrane (IMEM) before and after surgery.Methods A total of 21 patients with IMEM (21 eyes; 10 males and 11 females aged 42-83 years) admitted to the Department of Ophthalmology, the First Affiliated Hospital of Bengbu Medical College from February 2019 to February 2020 were retrospectively researched. All patients underwent the 25G vitrectomy combined with the epidermal macular dissection. The visual acuity measurement and the OCTA examination were performed three months after surgery. The best corrected visual acuity(BCVA), CMT, foveal avascular area (FAZ) , vessel density of superficial capillary plexus (SVD), vessel density of deep capillary plexus (DVD), and changes in the morphological structure of the macula were compared before and after surgery.Results All 21 patients successfully completed the operation. The operation time was 40-65 minutes (average=50 minutes). After the operation, three patients developed the high intraocular pressure, and one patient developed the anterior chamber inflammation, which was cured after corresponding treatment. The 21 patients were followed up for three months after the operation. The best corrected visual acuity (0.61±0.26) of the patients was significantly improved three months after the operation (0.82±0.32; t=2.588, P＜0.05). The results of the OCTA examination three months after the operation showed that the CMT ([287.05±64.79] μm) was significantly lower than before the operation ([469.33±101.88] μm), and the difference was statistically significant(t=7.050, P＜0.05). The postoperative FAZ area (0.19±0.12) mm2 and the SVD (52.50%±12.62%) were significantly increased compared with the preoperative FAZ area (0.13±0.10) mm2 and the SVD (48.58%±11.96%), and the differences were statistically significant(t=2.330, 4.358, all P values＜0.05); while DVD was 35.90%±10.52%, which was compared with 34.60%±9.61%, the difference was not statistically significant (P＞0.05). The shape of the fovea basically recovered, and the macular edema was reduced after three months.Conclusions The OCTA is a new noninvasive vascular imaging technology. The application of OCTA can observe the structure and the blood flow changes in the macular area of patients with IMEM after surgery and provide imaging evidence for the evaluation of the surgical effects after the vitrectomy combined with the macular peeling.
张锐, 高自清, 王爱芹. 光学相干断层扫描血管成像在特发性黄斑前膜玻璃体切除术后疗效观察中的应用[J]. 中华解剖与临床杂志, 2021, 26(1): 78-82.
Zhang Rui, Gao Ziqing, Wang Aiqin. Application of the optical coherence tomography angiography in the observation of the curative effect after the idiopathic macular vitrectomy. Chinese Journal of Anatomy and Clinics, 2021, 26(1): 78-82.
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2021, Vol. 26 
