epiretinal membrane
Introduction
Introduction to the posterior retina Subretinal membranes (SRMs), or subretinal membranes, are cell proliferative membranes on the outer surface of the retina and are a component of the membrane surrounding the retina. SRM generally does not have a significant impact and does not require surgery. However, about a quarter of the SRM needs to be surgically cut or removed in order to reset the retina. basic knowledge The proportion of sickness: 0.0004%-0.0007% Susceptible people: no special people Mode of infection: non-infectious Complications: retinal detachment
Cause
Cause of posterior retinal membrane
Causes:
SRM is common in patients with rhegmatogenous retinal detachment and retinal detachment, but can also be seen in the following cases: retinal vascular disease, such as Coats disease, diabetic retinopathy, retinal hemangioma, central retinal vein occlusion, posterior retinal fibrosis uveal Inflammatory syndrome, intraocular tumors such as iris and choroidal melanoma, and retinopathy of prematurity, etc., but the treatment of SRM is mainly related to the surgical reduction of rhegmatogenous retinal detachment.
Pathogenesis:
It has been thought that SRM is composed of subretinal fibrin coagulation. In 1980, Machemer surgery successfully removed SRM, making histological research possible. It has been confirmed that RPE cells are the main cellular components, and other glial cells and macrophages are also visible. Cells, fibroblasts, myofibroblasts, etc., similar to the cellular components of the preretinal membrane, RPE can be transformed into macrophage-like, fibroblast-like and myofibroblasts in different biochemical environments, and have synthetic collagen. The ability of macrophages to be involved in the proliferation of glial cells and the transformation of myofibroblasts. In addition to cellular components, collagen is the main matrix component of SRM, causing the posterior membrane to form a collagen-centered band or sheet-like structure. It is related to the tension and strength of the posterior membrane, and can resist the restoring force of the RPE layer. During the operation, it can be observed that the SRM is retracted back to the peripheral portion after being cut off.
Prevention
Retinal posterior membrane prevention
Bitter gourd luncheon meat: 250 grams of bitter gourd, washed and broken, simmered in melon, filled with 250 grams of luncheon meat, filled tightly, steamed on the basket, served with meals. It can clear the heat and cool the liver, improve the eyes and moisten the spleen. Suitable for heat injury camp blood, intraocular hemorrhage.
Dianthus rabbit Ding: use 50 grams of cactus to stab, choose 150 grams of fresh celery to wash, put together in boiling water to boil one or two boiling. Remove the cactus and cut the celery into small pieces. Cut 500 grams of rabbit meat into small cubes, mix the three dishes, add rice vinegar and seasonings, mix well and eat. Can clear the liver and diarrhea, nourishing yin and cooling blood. Applicable to fundus hemorrhage with partial hepatic fire.
Complication
Retroretinal complications Complications
Contraction of the posterior membrane of the retina can cause the retina to produce fixed folds and even retinal detachment.
Symptom
Retroretinal symptoms common symptoms retinal edema retinal hemorrhage
SRM mainly relies on ophthalmoscopy and surgery, especially the latter has a higher detection rate. Under the ophthalmoscope and the three-mirror slit lamp, SRM is the earliest yellow-white point under the retina. The study confirmed that these points are RPE cells transform into macrophage-like cells, which later become fibroblast-like cells, form a membrane and grow under the retina. The thickness of the membrane varies. When the cells contract, the weak part of the membrane ruptures to form a gap. The cells contract further, while the dense part of the membrane remains, resulting in a gray, grayish-yellow or gray-white rough shale-like, map-like, irregularly branched band, with a retina outer layer and an RPE layer of 1 or Multi-point adhesion, because the band is often composed of cells differentiated from RPE cells, it is usually dark brown, and glial cells are often multi-point origin, diffuse hyperplasia, easy to maintain a complete sheet structure, usually It is non-pigmented and does not cause retinal shrinkage and is therefore not easily identifiable.
Examine
Examination of the posterior membrane of the retina
No special laboratory tests.
Ophthalmoscopy examination reveals yellow-white spots under the retina or forms retinal bands of different shapes due to pulling.
Diagnosis
Retroperitoneal membrane diagnosis
According to the fundus performance, the diagnosis has certain difficulty, and it is easy to find and confirm the diagnosis in the retinal detachment surgery.
Clinically, SRM needs to be distinguished from the demarcation line of retinal detachment. The boundary line is formed by the detachment and the adjacent retina. It is convex toward the serrated margin. It is more common in the lower retinal detachment. If the retinal detachment develops, there may be 2, 3 parallel dividing lines, which are significantly different from irregular SRM, and sometimes these two changes exist simultaneously.
