Gonzales C R, Gupta A, Schwartz S D, Kreiger A E
Jules Stein Eye Institute, Department of Ophthalmology, University of California, UCLA David Geffen School of Medicine, Los Angeles 90095, USA.
Br J Ophthalmol. 2004 Nov;88(11):1400-2. doi: 10.1136/bjo.2004.043240.
Primary phakic rhegmatogenous retinal detachment (RRD) without posterior vitreous detachment (PVD) represents a unique clinical entity that behaves differently from RRD associated with PVD. While previous studies have reported the long term findings in the fellow eye of patients with RRD and PVD, the outcome of the fellow eye of patients with RRD without PVD is not known.
Consecutive patients with RRD not associated with PVD were studied retrospectively. The authors evaluated the fellow eye for retinal detachment or other vision threatening pathology.
27 patients (mean age 32 years) were studied with follow up of between 9 and 326 months (mean 111 months). 24 (89%) were myopic. Bilateral retinal detachment occurred in eight patients (30%). On initial examination, 17 patients (63%) had retinal findings (including lattice degeneration, atrophic holes, and/or cystic retinal tufts) in the fellow eye that might predispose them to retinal detachment. 14 vision threatening events or diagnoses occurred (nine of which were rhegmatogenous in nature) in the fellow eye including eight retinal detachments, one traumatic PVD without retinal tears, one retinal tear after PVD, one diagnosis of pigmentary glaucoma needing trabeculectomy, two visually significant cataracts, and one diagnosis of chorioretinitis. 23 patients (85%) maintained visual acuity better than 20/50, with most retaining 20/20 vision in the fellow eye.
Patients who experience RRD without PVD are at risk of developing vision threatening events in the contralateral eye and, as such, the fellow eye should be followed carefully.
原发性晶状体性孔源性视网膜脱离(RRD)且无玻璃体后脱离(PVD)代表一种独特的临床实体,其表现与伴有PVD的RRD不同。虽然既往研究报告了RRD伴PVD患者对侧眼的长期研究结果,但RRD不伴PVD患者对侧眼的转归尚不清楚。
对连续的不伴有PVD的RRD患者进行回顾性研究。作者评估对侧眼是否存在视网膜脱离或其他威胁视力的病变。
对27例患者(平均年龄32岁)进行了研究,随访时间为9至326个月(平均111个月)。24例(89%)为近视患者。8例患者(30%)发生双侧视网膜脱离。初次检查时,17例患者(63%)的对侧眼存在可能使其易患视网膜脱离的视网膜病变(包括格子样变性、萎缩性裂孔和/或视网膜囊肿样簇)。对侧眼发生了14次威胁视力的事件或诊断(其中9次为孔源性),包括8例视网膜脱离、1例无视网膜裂孔的外伤性PVD、1例PVD后视网膜裂孔、1例需要小梁切除术的色素性青光眼诊断、2例有明显视力影响的白内障以及1例脉络膜视网膜炎诊断。23例患者(85%)的视力保持在20/50以上,大多数对侧眼保留20/20视力。
发生RRD且无PVD的患者对侧眼有发生威胁视力事件的风险,因此,应对对侧眼进行密切随访。