Bains Harshivinderjit S, Patel Milan R, Singh Harinderjit, Marcus Dennis M
Department of Ophthalmology, Medical College of Georgia, 1120 15th Street, Augusta, GA 30912, USA.
Retina. 2003 Aug;23(4):469-74. doi: 10.1097/00006982-200308000-00004.
To report the visual outcomes and complications of surgical removal of extensive peripapillary choroidal neovascularization (PPCNV) in elderly patients.
Retrospective review.
Seventeen consecutive eyes of 17 patients older than age 55 undergoing PPCNV resection.
Retrospective review of eyes undergoing surgical removal of extensive PPCNV via pars plana vitrectomy.
Preoperative and postoperative Snellen visual acuity.
The mean age of patients was 76.9 years, and the mean duration of follow-up was 29.8 months. In 6 of 17 eyes, the PPCNV was extrafoveal; in two eyes, it was juxtafoveal; and in nine eyes, it was subfoveal. The cause of CNV was idiopathic (nine eyes), age-related macular degeneration (six eyes), presumed ocular histoplasmosis syndrome (one eye), and inflammation (one eye). All eyes were ineligible for laser treatment by MPS criteria. In eyes with extrafoveal CNV, the preoperative Snellen visual acuity ranged from 20/25 to 20/300, and the final visual acuity ranged from 20/40 to 20/800. The two eyes with juxtafoveal CNV had preoperative visual acuities of 20/125 and 20/300, and both had a postoperative acuity of 20/200. Eyes with subfoveal CNV had a range of preoperative visual acuity from 20/125 to 20/800, whereas the final visual acuity ranged from 20/30 to hand motions. Four of the nine eyes with subfoveal lesions had improved visual acuity. Overall, the final visual acuity was stable or improved in six eyes and worsened in 11 eyes. CNV recurrence was noted in four eyes and required reexcision, laser photocoagulation, or both. Surgical complications included retinal detachment (two eyes), retinal hole and epiretinal membrane (one eye), cystoid macular edema (two eyes), and subsequent cataract extraction (four eyes).
Surgical removal of extensive PPCNV in the elderly does not often yield improvement or stabilization of visual acuity. However, 6 of 17 patients had stable or improved visual acuity.
报告老年患者广泛的视乳头周围脉络膜新生血管（PPCNV）手术切除后的视力结果及并发症。
回顾性研究。
17例年龄大于55岁接受PPCNV切除术患者的17只连续眼。
回顾性研究经平坦部玻璃体切除术手术切除广泛PPCNV的眼。
术前及术后Snellen视力。
患者平均年龄76.9岁，平均随访时间29.8个月。17只眼中，6只眼的PPCNV位于黄斑中心凹外；2只眼位于黄斑中心凹旁；9只眼位于黄斑中心凹下。脉络膜新生血管（CNV）的病因是特发性（9只眼）、年龄相关性黄斑变性（6只眼）、疑似眼组织胞浆菌病综合征（1只眼）和炎症（1只眼）。根据MPS标准，所有眼均不适合激光治疗。黄斑中心凹外CNV的眼，术前Snellen视力范围为20/25至20/300，最终视力范围为20/40至20/800。2只黄斑中心凹旁CNV的眼术前视力分别为20/125和20/300，术后视力均为20/200。黄斑中心凹下CNV的眼术前视力范围为20/125至20/800，而最终视力范围为20/30至手动视力。9只黄斑中心凹下病变的眼中有4只视力提高。总体而言，6只眼最终视力稳定或提高，11只眼视力恶化。4只眼出现CNV复发，需要再次切除、激光光凝或两者兼用。手术并发症包括视网膜脱离（2只眼）、视网膜裂孔和视网膜前膜（1只眼）、黄斑囊样水肿（2只眼）以及随后的白内障摘除（4只眼）。
老年患者广泛PPCNV的手术切除通常不能提高或稳定视力。然而，17例患者中有6例视力稳定或提高。
