망막과 망막색소상피의 복합과오종에 동반된 망막전막 수술 시 내경계막 제거의 효과
Effects of Internal Limiting Membrane Peeling in Combined Hamartoma of Retina and Retinal Pigment Epithelium
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목적: 망막과 망막색소상피의 복합과오종에 동반된 망막전막에서 망막전막 제거 시 부가적인 내경계막 제거가 수술결과에 미치는 영향을 알아보고, 특발성 망막전막의 결과와 비교해 보고자 하였다. 대상과 방법: 망막과 망막색소상피의 복합과오종에 동반된 망막전막 환자 11명, 11안을 대상으로 망막전막제거술만 시행한 군(6명, 6 안)과 부가적인 내경계막제거술을 병행한 군(5명, 5안), 특발성 망막전막 환자 22명 22안을 대상으로 망막전막제거술만 시행한 군(12 명, 12안)과 부가적인 내경계막제거술을 병행한 군(10명, 10안) 간의 해부학적 결과, 기능적 결과, 합병증, 재발을 후향적으로 조사하여 비교 분석하였다. 결과: 망막과 망막색소상피의 복합과오종의 망막전막과 특발성 망막전막 환자 모두에서 망막전막제거술만 시행한 군과 부가적인 내경계막제거술을 병행한 군 모두 유의하게 중심망막두께와 중심와아래 맥락막두께가 감소하고, 최대교정시력 또한 유의한 향상이 있었다. 하지만, 망막전막제거술만 시행한 군과 부가적인 내경계막제거술을 병행한 군 간의 중심망막두께, 중심와아래 맥락막두께, 최대교정시력의 유의한 차이는 없었다. 네 군 모두 합병증과 재발은 없었다. 결론: 망막과 망막색소상피의 복합과오종에 동반된 망막전막 환자와 특발성 망막전막 환자에서 망막전막제거술 시행 시 효과적인 병변의 호전 및 시력의 호전을 가져올 수 있었다. 하지만 부가적인 내경계막 제거로 인한 유의한 효과는 없었다.
Abstract
Purpose: To evaluate the effects of peeling the internal limiting membrane (ILM) of an epiretinal membrane (ERM) for surgical treatment of combined hamartoma of the retina and retinal pigment epithelium (RPE). Methods: We retrospectively reviewed the records of 11 patients (11 eyes) with ERM of combined hamartoma of the retina + RPE and 22 patients (22 eyes) with idiopathic ERM who treated with pars plana vitrectomy and removal of the ERM. The patients were divided into four groups: involving eyes with (5 eyes) or without (6 eyes) ILM peeling in combined hamartoma of the retina + RPE group and eyes with (10 eyes) or without (12 eyes) ILM peeling in the idiopathic ERM group. Anatomical outcomes, functional outcomes, complications and recurrences were compared between eyes with and without ILM peeling. Results: Central retinal thickness (CRT) and subfoveal choroidal thickness (SFCT) decreased and postoperative best-corrected visual acuity (BCVA) improved regardless of ILM peeling in all groups. There were no statistically significant differences in CRT, SFCT and BCVA between without and with ILM peeling in ERM of combined hamartoma of the retina + RPE and idiopathic ERM groups. There were no complications and recurrences in any group. Conclusions: The additional ILM peeling did not affect the postoperative results.
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