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非年龄相关性黄斑变性所致黄斑中心凹下脉络膜新生血管的下方局限性黄斑转位术的初步经验

Initial experience of inferior limited macular translocation for subfoveal choroidal neovascularization resulting from causes other than age-related macular degeneration.

作者信息

Fujii G Y, Humayun M S, Pieramici D J, Schachat A P, Au Eong K G, de Juan E

机构信息

Wilmer Ophthalmological Institute, The Johns Hopkins University School of Medicine., Baltimore, Maryland, USA.

出版信息

Am J Ophthalmol. 2001 Jan;131(1):90-100. doi: 10.1016/s0002-9394(00)00769-8.

Abstract

PURPOSE

To report our initial experience of inferior limited macular translocation in patients with subfoveal choroidal neovascularization resulting from causes other than age-related macular degeneration.

METHODS

We conducted a retrospective study of 23 eyes of 22 patients with choroidal neovascularization involving the foveal center secondary to pathologic myopia (11 eyes), ocular histoplasmosis syndrome (four eyes), angioid streaks (four eyes), idiopathic neovascularization (three eyes), and multifocal choroiditis (one eye), in which the fovea was moved inferiorly by means of limited macular translocation surgery. The mean preoperative best-corrected visual acuity was 20/150, and in five of 23 eyes (21.7%) the visual acuity was 20/80 or better. The major outcome measures were preoperative and postoperative visual acuity, postoperative foveal displacement, and complications related to the surgery.

RESULTS

The mean postoperative follow-up was 10.82 months (range, 6 to 18 months). Postoperative best-corrected visual acuity improved by 2 or more Snellen lines of visual acuity in 11 of 23 eyes (47.82%), remained within 1 line in seven of 23 eyes (30.43%), and worsened 2 or more lines of vision in five of 23 eyes (21.74%). The mean postoperative best-corrected visual acuity was 20/100, and in 12 of the 23 eyes (52.17%) the visual acuity achieved was 20/80 or better. Retinal detachment was the most frequent complication and occurred in six eyes (26%).

CONCLUSIONS

Our initial experience with limited macular translocation shows that this treatment modality offers the potential to improve visual function in some eyes with subfoveal choroidal neovascularization secondary to myopia, ocular histoplasmosis syndrome, angioid streaks, idiopathic neovascularization, and multifocal choroiditis. Although longer and more complete follow-up is needed, the results of this initial series warrant further studies to define the precise role of macular translocation in the management of these conditions.

摘要

目的

报告我们对因年龄相关性黄斑变性以外的原因导致的黄斑中心凹下脉络膜新生血管患者进行下方局限性黄斑移位术的初步经验。

方法

我们对22例脉络膜新生血管累及黄斑中心凹的患者的23只眼进行了一项回顾性研究,这些患者继发于病理性近视(11只眼)、眼组织胞浆菌病综合征(4只眼)、血管样条纹(4只眼)、特发性新生血管形成(3只眼)和多灶性脉络膜炎(1只眼),通过局限性黄斑移位手术将黄斑中心凹向下移位。术前平均最佳矫正视力为20/150,23只眼中有5只眼(21.7%)的视力为20/80或更好。主要观察指标为术前和术后视力、术后黄斑移位情况以及与手术相关的并发症。

结果

术后平均随访时间为10.82个月(范围6至18个月)。23只眼中有11只眼(47.82%)术后最佳矫正视力提高了2行或更多Snellen视力行,23只眼中有7只眼(30.43%)保持在1行以内,23只眼中有5只眼(21.74%)视力下降了2行或更多。术后平均最佳矫正视力为20/100,23只眼中有12只眼(52.17%)达到的视力为20/80或更好。视网膜脱离是最常见的并发症,发生在6只眼(26%)。

结论

我们对局限性黄斑移位术的初步经验表明,这种治疗方式有可能改善一些因近视、眼组织胞浆菌病综合征、血管样条纹、特发性新生血管形成和多灶性脉络膜炎导致的黄斑中心凹下脉络膜新生血管患者的视功能。尽管需要更长时间和更全面的随访,但这一初步系列研究的结果值得进一步研究,以确定黄斑移位在这些疾病治疗中的精确作用。

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