Сканирующая лазерная офтальмоскопия в диагностике ламеллярного макулярного разрыва с эпиретинальной пролиферацией

Abstract

Optical coherence tomography (OCT) technology has determined the possibility of in vivo study of morphostructural and morphometric changes in the central zone of the retina, including epiretinal proliferation. Scanning laser ophthalmoscopy (SLO) allows assessing changes in the vitreoretinal interface and chorioretinal complex "at different depths", the use of this method for lamellar macular holes (LMR) can be used not only for diagnosis, but also for assessing changes and the extent of the process. Purpose. To determine the possibilities of SLO in diagnosing and assessing the prevalence of epiretinal proliferation in lamellar macular holes in comparison with OCT data. Material and methods. In a study conducted on the basis of S. Fyodorov Eye Microsurgery Federal State Institution, Saint Petersburg branch, 48 patients with an established diagnosis of LMR were included, while epiretinal proliferation was diagnosed in 27 (52.6%) patients by OCT. SLO was performed in 21 patients with epiretinal proliferation diagnosed by OCT. Results. The best visualization of epiretinal proliferation was achieved by processing the image with a decrease in the intensity of red and an increase in blue and green. With epiretinal proliferation, there was a lower maximum correctable visual acuity and pronounced structural changes in the retina: a foveolar tubercle in 6 (12.5%) patients, a violation of the ellipsoidal zone in 10 (20.8%) of 48 patients, while its length was 110.26±19.85 µm. An inverse correlation was established between the values of the epiretinal proliferation area and the index of the minimum retinal thickness (R=-0.7, P=0.005), which indirectly confirms the gradual loss of retinal tissue during LMR due to the development of epiretinal proliferation. Conclusion. The performance of SLO allows visualization of epiretinal proliferation and determination of its area, which can be useful both in the dynamic observation of LMR and in planning surgical treatment for this pathology.