黄斑前膜How to确诊
Jul 03, 2019
Source: Cainiu Health
Dr. Yao Bo
Introduction
当出现黄斑前膜的时候，Patient会感觉到视力有影响。盯细微的结构的时候，会有视物变形的改变，比如细小的格线，会发现在某一个中心点、某一个地方可以出现线条的扭曲、变形。当有这种情况的时候，就需要到眼科去Examination。
When an epiretinal membrane (ERM) develops, patients typically notice visual impairment. When focusing on fine details—such as delicate grid lines—they may experience metamorphopsia (distorted vision), wherein straight lines appear wavy or bent at a specific central point or localized area. If such symptoms occur, patients should seek evaluation by an ophthalmologist.
Current ophthalmic diagnostic approaches include pupillary dilation to enable direct fundoscopic examination of the macula for visible structural changes. In early stages of ERM, subtle, crinkled, cellophane-like alterations may be observed; as the condition progresses, thicker, more opaque fibrous membranes may develop, causing distortion and traction-induced deformation of retinal vessels surrounding the macula.
A particularly important and relatively recent diagnostic modality is optical coherence tomography (OCT) of the retina. OCT enables high-resolution cross-sectional imaging of the macula, clearly revealing the morphology, thickness, and degree of traction exerted by the epiretinal membrane—making it a cornerstone in diagnosis. In advanced cases, fluorescein angiography may further demonstrate vascular tortuosity and leakage resulting from mechanical traction—findings that also support the diagnosis.
Once an epiretinal membrane forms, progressive deterioration of central vision typically ensues. The only effective treatment is vitreoretinal surgery: using microsurgical instruments inserted via pars plana vitrectomy, the membrane is carefully peeled away from the underlying healthy retina to restore normal retinal anatomy and thereby improve visual function and acuity.
