Hirakata Akito, Okada Annabelle A, Hida Tetsuo
Kyorin Eye Center, Department of Ophthalmology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan.
Ophthalmology. 2005 Aug;112(8):1430-5. doi: 10.1016/j.ophtha.2005.02.013.
To evaluate the efficacy of vitrectomy and gas tamponade, without laser photocoagulation to the margin of the optic nerve, for the treatment of macular detachment associated with an optic disc pit.
Noncomparative interventional case series.
Eleven consecutive patients (8-47 years of age) who presented with unilateral macular detachment associated with an optic disc pit.
Pars plana vitrectomy, induction of posterior vitreous detachment (PVD), and gas tamponade were performed, with postoperative facedown positioning for 1 week. The presence of a double-layer detachment consisting of an inner layer separation and an outer layer detachment was observed in 10 of 11 eyes either preoperatively or postoperatively. Patients were observed for 10 to 98 months (mean, 47) after surgery.
Anatomic outcome and visual acuity were retrospectively analyzed for all eyes. Optical coherence tomography was used to observe anatomic changes in the macula in some eyes.
Complete retinal reattachment was achieved in 10 of 11 eyes, although these eyes required nearly 1 year to reach this state. The one eye with persistent retinal detachment was observed to have a marked reduction of the detachment by 10 months postoperatively. No recurrences were observed. Visual acuity improvement was documented in 7 of 11 eyes.
These results suggest that vitrectomy with induction of PVD and gas tamponade, without additional laser treatment, is successful in reattaching the macula and improving central vision in most patients with optic disc pit maculopathy.
评估在不进行视神经边缘激光光凝的情况下，玻璃体切除术联合气体填塞治疗与视盘小凹相关的黄斑脱离的疗效。
非对照性干预病例系列。
11例连续的患者（年龄8 - 47岁），均表现为单侧与视盘小凹相关的黄斑脱离。
行平坦部玻璃体切除术、诱导玻璃体后脱离（PVD）及气体填塞，术后俯卧位1周。11眼中有10眼在术前或术后观察到存在由内层分离和外层脱离组成的双层脱离。术后对患者进行了10至98个月（平均47个月）的观察。
对所有患眼进行解剖学结果和视力的回顾性分析。部分患眼使用光学相干断层扫描观察黄斑的解剖学变化。
11眼中有10眼实现了视网膜完全复位，尽管这些眼达到此状态需要近1年时间。1例视网膜持续脱离的患眼在术后10个月时脱离程度明显减轻。未观察到复发情况。11眼中有7眼视力得到改善。
这些结果表明，在不进行额外激光治疗的情况下，通过玻璃体切除术诱导PVD并联合气体填塞，大多数视盘小凹黄斑病变患者的黄斑能够成功复位，中心视力得以改善。
