Sato Yukihiro, Lee Zeon, Shimada Hiroyuki
Department of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan.
Jpn J Ophthalmol. 2002 May-Jun;46(3):315-22. doi: 10.1016/s0021-5155(02)00471-9.
We evaluated visual outcomes following vitrectomy for diabetic cystoid macular edema.
Visual outcomes and factors possibly influencing final visual acuity were assessed and documented retrospectively in 45 eyes of 40 patients, all of whom were followed up for at least 6 months postoperatively.
Compared with the preoperative logarithm of the minimum angle of resolution (logMAR) visual acuity, final logMAR visual acuity improved 0.2 or more in 51% of the eyes, was unchanged in 47%, and decreased 0.2 or more in 2%. A final postoperative visual acuity of 0.5 or better was achieved in 38%. Preoperative visual acuity and the extent of the cystoid space on fluorescein angiography were significantly related to final visual acuity. A final postoperative visual acuity of 0.5 or better was noted in 8% of eyes with a preoperative visual acuity below 0.1, in 50% of eyes with a preoperative visual acuity of 0.1 or better, in 71% of eyes with a cystoid space smaller than 5 disc areas, and in 20% of eyes with a cystoid space of 5 disc areas or more. The state of the posterior vitreous membrane did not influence final visual acuity. There were no complications that decreased visual acuity.
We conclude that diabetic cystoid macular edema is a good indication for vitrectomy, regardless of the state of the posterior vitreous membrane. A preoperative visual acuity of 0.1 or better and/or a cystoid space smaller than 5 disc areas may be indications for surgery aimed at achieving a final postoperative visual acuity of 0.5 or better.
我们评估了玻璃体切割术治疗糖尿病性黄斑囊样水肿后的视力预后。
回顾性评估并记录了40例患者45只眼的视力预后及可能影响最终视力的因素,所有患者术后均随访至少6个月。
与术前最小分辨角对数(logMAR)视力相比,51%的患眼最终logMAR视力提高0.2或更多,47%的患眼无变化,2%的患眼下降0.2或更多。38%的患眼术后最终视力达到0.5或更好。术前视力和荧光素血管造影显示的囊样腔范围与最终视力显著相关。术前视力低于0.1的患眼中,8%术后最终视力达到0.5或更好;术前视力为0.1或更好的患眼中,50%术后最终视力达到0.5或更好;囊样腔小于5个视盘面积的患眼中,71%术后最终视力达到0.5或更好;囊样腔为5个视盘面积或更大的患眼中,20%术后最终视力达到0.5或更好。玻璃体后皮质状态不影响最终视力。没有导致视力下降的并发症。
我们得出结论,无论玻璃体后皮质状态如何,糖尿病性黄斑囊样水肿都是玻璃体切割术的良好适应证。术前视力为0.1或更好和/或囊样腔小于5个视盘面积可能是旨在使术后最终视力达到0.5或更好的手术适应证。