多次光动力治疗后复发性脉络膜新生血管中玻璃体黄斑牵引的高发生率。
High incidence of vitreomacular traction in recurrent choroidal neovascularisation after repeated photodynamic therapy.
作者信息
Schmidt J C, Mennel S, Hörle S, Meyer C H
机构信息
Department of Ophthalmology, Philipps-University Marburg, Robert-Koch-Strasse 4, 35037 Marburg, Germany.
出版信息
Br J Ophthalmol. 2006 Nov;90(11):1361-2. doi: 10.1136/bjo.2006.094201. Epub 2006 Jul 19.
BACKGROUND
The causes of recurrent choroidal neovascularisation (CNV) after photodynamic therapy (PDT) remain controversial. Subretinal surgery was carried out after unsuccessful PDT.
AIMS
To determine intraoperatively the status of the posterior vitreous interface.
DESIGN
Interventional case series.
METHODS
Conventional three-port vitrectomy was carried out in 10 eyes with CNV that had undergone 1-4 PDT sessions. The vitreous cutter was held close to the edge of the optic nerve to evaluate the status of the posterior vitreous.
RESULTS
Lesion size showed an increase from 1.5 (standard deviation (SD) 0.53) to 2.3 (SD 0.83) macular photocoagulation study disc diameters, between the first and the last PDT. Intraoperative findings during vitrectomy showed little liquefaction of the vitreous gel and an incomplete posterior-vitreous detachment, with remarkably firm attachments at the macula in all cases (10/10).
CONCLUSION
We determined an abnormally high incidence of vitreous attachments in eyes with recurrent CNV. Vitreomacular attachments may trigger the progression or recurrence of CNV.
背景
光动力疗法（PDT）后脉络膜新生血管（CNV）复发的原因仍存在争议。在PDT治疗失败后进行了视网膜下手术。
目的
术中确定玻璃体后界膜的状态。
设计
干预性病例系列研究。
方法
对10只患有CNV且已接受1 - 4次PDT治疗的眼睛进行常规三通道玻璃体切除术。将玻璃体切割器靠近视神经边缘以评估玻璃体后界膜的状态。
结果
在首次和末次PDT之间，病变大小从1.5（标准差（SD）0.53）个黄斑光凝研究视盘直径增加到2.3（SD 0.83）个。玻璃体切除术中的发现显示玻璃体凝胶几乎没有液化，玻璃体后脱离不完全，所有病例（10/10）在黄斑处均有明显牢固的附着。
结论
我们确定复发性CNV眼中玻璃体附着的发生率异常高。玻璃体黄斑附着可能触发CNV的进展或复发。
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