Effect of foveal herniation on surgical outcomes in patients with idiopathic epiretinal membrane

ABSTRACT Purpose: This study aimed to compare the anatomical and visual outcomes of idiopathic epiretinal membrane peeling surgery, with and without foveal herniation. Methods: This retrospective, comparative, two-center study included age- and sex-matched patients exhibiting an idiopathic epiretinal membrane with and without foveal herniation (epiretinal membrane + foveal herniation group and epiretinal-membrane-only group, respectively). The baseline best-corrected visual acuity and central foveal thickness were compared within the groups through months 1, 3, 6, and 12 of follow-up postoperatively. Then, changes in these two parameters at all follow-up points were compared between the groups. Results: We enrolled 16 patients per study group. The baseline best-corrected visual acuity and central foveal thickness were not significantly different between the two groups (p>0.05). Compared with the baseline, both the best-corrected visual acuity and central foveal thickness improved significantly in both groups in all follow-ups (p<0.05), except for the best-corrected visual acuity of the epiretinal-membrane-only group after month 1 (p<0.05). The mean best-corrected visual acuity improvement after month 1 and the mean central foveal thickness reduction after months 1, 3, and 6 were significantly better in the foveal herniation + epiretinal membrane group than in the epiretinal-membrane-only group (p<0.05). However, the best-corrected visual acuity and central foveal thickness changes were not significantly different between the groups at the final visit (p>0.05). Conclusions: Although epiretinal membrane + foveal herniation demonstrated prompt anatomical and functional improvement, foveal herniation occurrence did not affect the final surgical outcomes in patients with idiopathic epiretinal membrane.

摘要

## 研究目的
本研究旨在对比伴与不伴黄斑疝（foveal herniation）的特发性视网膜前膜（idiopathic epiretinal membrane）剥离手术的解剖学与视觉预后效果。

## 研究方法
本项回顾性对照双中心研究纳入了年龄与性别匹配的特发性视网膜前膜伴或不伴黄斑疝的患者，分别设为视网膜前膜+黄斑疝组与单纯视网膜前膜组。于术后1、3、6、12个月进行随访，对比两组患者基线最佳矫正视力（best-corrected visual acuity）与中心凹厚度（central foveal thickness）的组内变化情况，并比较两组在各随访时点的上述两项参数的变化差异。

## 研究结果
本研究每组纳入16例患者。两组患者的基线最佳矫正视力与中心凹厚度均无显著统计学差异（p>0.05）。与基线水平相比，两组在各随访时点的最佳矫正视力与中心凹厚度均得到显著改善（p<0.05），仅单纯视网膜前膜组术后1个月的最佳矫正视力这一指标除外（p<0.05）。黄斑疝+视网膜前膜组术后1个月后的平均最佳矫正视力提升幅度，以及术后1、3、6个月的平均中心凹厚度减少幅度，均显著优于单纯视网膜前膜组（p<0.05）。但在末次随访时，两组的最佳矫正视力与中心凹厚度变化均无显著统计学差异（p>0.05）。

## 研究结论
尽管伴黄斑疝的特发性视网膜前膜可实现快速的解剖学与功能改善，但黄斑疝的存在并未对特发性视网膜前膜患者的最终手术预后产生影响。