Yonemura N, Hirata A, Hasumura T, Negi A
Department of Ophthalmology, Kumamoto University School of Medicine, Kumamoto, Japan.
Ophthalmology. 2001 Sep;108(9):1638-43. doi: 10.1016/s0161-6420(01)00677-7.
Visual field defects are one of the complications of macular hole surgery, and mechanical retinal damage induced by infusion air is a proposed causative factor of this complication. In this study, we examined the fundus to see whether the changes observed corresponded to postoperative visual field defects.
Observational case series.
Seventeen eyes of 17 patients who had postoperative visual field defects after vitrectomy for idiopathic macular hole were examined.
The fundus was examined by ophthalmoscopy and by fluorescein and indocyanine green angiography.
Fundus changes corresponding to postoperative visual field defects.
In eight eyes, detectable fundus changes were observed, including regional mottling and degeneration of the retinal pigment epithelium, filling delay of the choroidal circulation, subretinal fibrosis, and epiretinal membrane formation. These findings corresponded exactly to the visual field defects observed. Although the visual field defects had been detected shortly after surgery, fundus changes were detected, on average, more than 8 months after surgery.
Fundus changes become apparent after surgery, and they are progressive. Therefore, it is important to examine eyes with visual field defects for a follow-up period of several years.
视野缺损是黄斑裂孔手术的并发症之一，注入空气引起的机械性视网膜损伤被认为是该并发症的一个致病因素。在本研究中，我们检查眼底，以观察所观察到的变化是否与术后视野缺损相对应。
观察性病例系列。
对17例特发性黄斑裂孔玻璃体切除术后出现视野缺损的患者的17只眼进行了检查。
通过检眼镜检查以及荧光素和吲哚菁绿血管造影检查眼底。
与术后视野缺损相对应的眼底变化。
在8只眼中观察到了可检测到的眼底变化，包括视网膜色素上皮的区域性斑驳和变性、脉络膜循环充盈延迟、视网膜下纤维化以及视网膜前膜形成。这些发现与所观察到的视野缺损完全对应。尽管视野缺损在手术后不久就被检测到，但眼底变化平均在手术后8个月以上才被检测到。
眼底变化在手术后变得明显，并且是进行性的。因此，对有视野缺损的眼睛进行数年的随访检查很重要。
