| Purpose:Postoperative retinal displacement of idiopathic macular epiretinal membrane(IMEM)is a new concept that has been proposed and attracted attention in recent years,which is closely related to postoperative visual quality,especially visual deformation and recovery of macular microstructure.The purpose of this study was to analyze the variation rule of retinal displacement after IMEM surgery,and to summarize the related factors affecting the retinal displacement of IMEM,so as to provide theoretical basis for clinical evaluation of the prognosis of patients with IMEM.Method:In this study,we retrospectively analyzed 55 IMEM patients with 56 eyes treated at our hospital from January 2018 to October 2022,and collected best corrected visual acuity(BCVA),optical coherence tomography(OCT)images on On the OCT infrared fundus images,the fovea(F)to optic disk(OD),superior temporal vessel(STV),inferior temporal vessel(ITV),superior temporal vessel to inferior temporal vessel distance(STV-ITV),and perimacular area(PMA)were calculated to evaluate the degree of retinal displacement,and compared the changes of BCVA,inner nuclear layer(INL)thickness,ectopic inner foveal layers(EIFL)thickness,central foveal thickness(CFT)and retinal displacement before and after surgery,and analyzed the correlation between them.Results:1.The mean BCVA(Log MAR)at 1week,1month,and 3months postoperatively was0.84±0.33,0.81±0.35,and 0.61±0.26,respectively,compared with 0.90±0.41preoperatively,and the postoperative visual acuity was significantly improved and statistically different(x~2=32.13,P<0.05).2.The mean INL thickness at 1 week,1 month,and 3 months postoperatively was69.79±19.50um,54.75±12.84um,and 44.68±8.45um,respectively,with a statistically significant reduction in INL thickness compared with 87.11±27.44um preoperatively(F=45.95,P<0.05).3.The mean EIFL thickness at 1 week,1 month,and 3 months postoperatively was155.80±58.45um,130.23±48.27um,and 119.96±43.92um,respectively,compared with the preoperative thickness of 170.29±71.05um,which was statistically different(F=49.97,P<0.05).4.The mean CFT of patients at 1 week,1 month and 3 months postoperatively were467.87±73.92um,416.30±60.85um and 371.46±43.69um,respectively,which were statistically significantly reduced compared with 486.82±94.85um preoperatively(F=47.90,P<0.05).5.The mean F-OD of patients at 1 week,1 month,and 3 months postoperatively was3584.39±212.38um,3508.01±202.37um,and 3496.44±208.40um,respectively,with a statistically significant decrease in F-OD compared with 3615.64±227.52um preoperatively(F=34.70,P<0.05).The mean change rate of F-OD displacement at 1 week,1 month,and 3 months postoperatively was 0.81±0.24%,2.88±1.35%,and 3.21±1.71%,respectively,and there was a statistical difference in the rate of F-OD displacement at 1month and 3 months postoperatively compared with 1 week postoperatively(x~2=19.84,P<0.05).6.The average F-STV of patients 1 week,1 month and 3 months after surgery was3996.59±555.18um,3984.57±568.50um and 4006.70±590.06um,respectively,which showed no statistical significance compared with preoperative 3970.79±546.38um(F=1.884,P>0.05).7.The average F-ITV at 1 week,1 month and 3 months after surgery was3381.68±544.98um,3398.32±551.98um and 3421.94±546.63um,respectively,which showed no significant difference compared with 3414.88±563.85um before surgery(F=3.383,P>0.05).8.The mean STV-ITV of patients at 1 week,1 month,and 3 months postoperatively was 5641.25±1059.30um,5642.39±1050.61um,and 5654.16±1057.90 um,respectively,which was slightly enlarged compared with 5603.23±1053.66um preoperatively,but not statistically significant(F=6.702,P>0.05).9.The mean PMA of patients at 1 week,1 month,and 3 months after surgery were 7135231.92±420744.71um~2,7332810.58±525033.44um~2,7392832.5±621909.84um~2,respectively.Compared with the preoperative 6938376.41±340392.16um~2,and the PMA was significantly enlarged and the difference was statistically significant(x~2=46.14,P<0.05).The rate of PMA change at 1 week,1 month,and 3 months postoperatively was 2.85±1.38%,5.67±3.07%,and 6.60±4.23%,respectively,and the differences were statistically significant at 1 month and 3 months postoperatively compared with the rate of PMA change at 1 week postoperatively(x~2=33.39,P<0.05).10.Postoperative BCVA(Log MAR)was significantly positively correlated with preoperative BCVA(Log MAR),INL thickness,EIFL thickness and CFT(r_s=0.410,0.383,0.319,0.297,P<0.05).There was no significant correlation between the change rate of F-OD displacement and PMA and BCVA(Log MAR)before and after surgery(P>0.05).The change rate of postoperative F-OD displacement was positively correlated with preoperative INL thickness,EIFL thickness and CFT(r_s=0.339,0.395,0.372,P<0.05).Postoperative PMA change rate was positively correlated with preoperative INL thickness,EIFL thickness and CFT(r_s=0.282,0.349,0.489,P<0.05).Conclusions:1.OCT infrared fundus images are available to measure the degree of retinal displacement.2.After PPV combined with macular epiretinal membrane peeling,retinal dilatation in macular region and the foveal moved nasally were observed.3.The greater retinal displacement after surgery was correlated with the thicker INL thickness,EIFL thickness and CFT before surgery.4.Preoperative INL thickness,EIFL thickness and CFT thickness were correlated with poor postoperative visual recovery. |
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