Retinal sensitivity and optical coherence tomography findings in eyes with idiopathic epiretinal membrane
Notice bibliographique
Résumé
Editor, Idiopathic epiretinal membrane (ERM) is a common eye disease. In practice, its functional impact is evaluated by measurement of best-corrected visual acuity (BCVA) and presence of metamorphopsia. Macular function may also be studied using microperimetry (Rohrschneider et al. 2008). The objective of this study was to analyse macular function by measuring its sensitivity using microperimetry in patients with idiopathic ERM and to correlate it to the BCVA and spectral-domain optical coherence tomography (SD-OCT) findings. We prospectively included 49 eyes of 49 consecutive patients with idiopathic ERM for which surgical treatment had been planned. We excluded patients with secondary ERM, severe media opacities, macular degeneration or other eye diseases that could influence VA. We considered as a control group 27 eyes of 27 patients with a normal BCVA (>78 letters) and a normal macular OCT profile. All patients had BCVA measured at 4 m with the standard Early Treatment Diabetic Retinopathy Study (ETDRS) chart (Precision Vision, La Salle, IL, USA), a slit-lamp examination and a dilated fundus ophthalmoscopy. Additional tests performed were microperimetry and macular OCT using OPKO/OTI (OPKO/Ophthalmic Technologies Inc., Toronto, ON, Canada). The topographic map and a macular sensitivity map were centred on the fovea and superimposed. For the evaluation of subtle retinal changes, a macular OCT using HRA-OCT (Heidelberg Engineering, Heidelberg, Germany) was performed. For microperimetry, we used the Polar 3 testing pattern, a Goldmann III stimulus, a 200-ms presentation time and a 4-2-1 staircase strategy. Polar 3 is a standardized grid composed of 28 dots arranged in three concentric circles (2.3°, 6.6° and 11° in diameter) within the central macula. The mean macular sensitivities (MS), central circle or foveal sensitivities (FS) and stability of fixation were recorded. The general characteristics of the patients are displayed in the Table 1. The BCVA, FS and MS were significantly lower (p = 0.0001), and foveal and macular thickness (FT, MT) and foveal and macular volume (FV, MV) were significantly higher (p = 0.0001) in eyes with ERM compared with control eyes (Table 1). In eyes with ERM, we found a significant correlation between retinal sensitivity (MS, FS) and BCVA (r = 0.563, p =0.0005 and r = 0.435, p = 0.038, respectively). A negative correlation was found between MS and MT (r = −0.441, p = 0.032). In the ERM group, patients with stable macular fixation (83.7%) had a significantly higher MS and BCVA than those with relatively unstable fixation (16.3%), (p = 0.003 and p =0.003, respectively). In the control group, only one patient had relatively unstable fixation (3.7%). Eyes with an abnormal inner/outer photoreceptor segment (IS/OS) junction (18.4%) and those with a disorganized retinal outer layer (36.7%) had significantly lower MS than eyes without these lesions in the ERM group (p = 0.001 and p = 0.007, respectively). Lower BCVA was associated with IS/OS junction abnormalities (p = 0.008). There are contradictory opinions on the influence of macular thickening on macular function, and few other studies have used microperimetry to evaluate macular function in ERM. Karacorlu et al. (2010) found similar results. Conversely, Pilli et al. (2011) found no relationship between sensitivity and MT, but they also included asymptomatic eyes. Moreover, it was shown that photoreceptor defects may be an important prognostic factor in patients with ERM (Kim et al. 2012; Shimozono et al. 2012). Microperimetry is complementary to VA measurement and OCT in the evaluation of eyes with ERM. We are conducting a longitudinal study to evaluate the changes in microperimetry and OCT findings after surgical treatment of ERM.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».