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목적 : Recently, novel developments in SD-OCT methods have facilitated a more detailed evaluation of the vitreoretinal surface in various disease. However, to our knowledge, the longitudinal systematic evaluation of ERM self separation and its tomographic characterization using SD-OCT have not been reported yet. Thus, the present study was performed to identify the prevalence and visual prognosis of ERM self-separation and to investigate the characteristics of spontaneous idiopathic ERM separation using SD-OCT.
방법 : This retrospective, observational, comparative, single-center study reviewed the electronic clinical records of consecutive patients over 20 years old and diagnosed with ERM at the Asan Medical Center between January 1, 2009 and December 31, 2012. From 1248 consecutive eyes with idiopathic ERM, group I with pre-existing posterior vitreous detachment (PVD) included 1091 eyes (87.4%) and group II without pre-existing PVD included 157 eyes (12.6%). Groups IA and IIA included only self-resolution cases among total ERM cases from groups I and II, respectively.
결과 : Self-resolution occurred in 37 eyes (3.0%) for 32.6 months, with 16 (1.5%) in Group IA and 21 (13.4%) in Group IIA. The mean BCVA (logMAR) improved in Groups IA and IIA by 0.1 (p=0.013) and 0.06 (p=0.078). From tomographic analyses, dominant undulation in retinal surface and RNFL defects were more frequent in group IA (p<0.024). However, completeness of ERM separation, IS/OS junction defects, and ERM recurrence were more frequent in group IIA (p<0.041). Multivariate analysis for factors related to visual improvement revealed only IS/OS junction defects as significantly associated (p=0.025).
결론 : Self separation of ERM was frequent observed in the present study, especially in patients without pre-existing PVD on SD-OCT. PVD induction or activation of a self-contraction mechanism during self-resolution promotes different aspects of retinal tomographic changes in SD-OCT analysis. Tomographic characteristics, including IS/OS junction integrity, observed during self-separation may affect post-separation visual prognosis.
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