Taban Mehran, Lewis Hilel, Lee Michael S
Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Graefes Arch Clin Exp Ophthalmol. 2007 Apr;245(4):600-5. doi: 10.1007/s00417-006-0420-5. Epub 2006 Oct 6.
Visual field defects after uncomplicated vitrectomy have been reported but poorly explained. We describe two cases of nonarteritic anterior ischemic optic neuropathy (NAION) observed following vitrectomy. We also reviewed the literature for cases of post-vitrectomy visual field defects for evidence of optic nerve damage.
Two patients developed optic disc edema and features of an optic neuropathy after uncomplicated vitrectomy for macular hole and epiretinal membrane. A systematic literature search was conducted to obtain prior reports of visual field defects or ischemic optic neuropathy following vitrectomy. Additional studies were identified from the bibliographies of the retrieved articles.
The incidence of visual field defects following vitrectomy has varied from 1-71% across all studies. Overall, we found 160 (14.5%) cases of unexplained visual field defects following vitrectomy out of 1,104 patients. Of these, 31 eyes (19.4%) have shown some sign of optic nerve damage following vitrectomy, including pallor in 29 eyes, relative afferent pupillary defect in eight eyes, and intrapapillary hemorrhage in two eyes.
NAION may develop following vitrectomy. "Visual field defects" following vitrectomy are common and many of the involved eyes demonstrate evidence of optic nerve damage, some of which may have represented NAION.
已有关于单纯玻璃体切除术后视野缺损的报道，但对此解释甚少。我们描述了两例玻璃体切除术后观察到的非动脉炎性前部缺血性视神经病变（NAION）。我们还查阅了文献，以寻找玻璃体切除术后视野缺损病例中视神经损伤的证据。
两名患者在因黄斑裂孔和视网膜前膜行单纯玻璃体切除术后出现视盘水肿和视神经病变特征。进行了系统的文献检索，以获取玻璃体切除术后视野缺损或缺血性视神经病变的既往报道。从检索到的文章的参考文献中确定了其他研究。
在所有研究中，玻璃体切除术后视野缺损的发生率在1%至71%之间。总体而言，我们在1104例患者中发现160例（14.5%）玻璃体切除术后出现无法解释的视野缺损。其中，31只眼（19.4%）在玻璃体切除术后出现了一些视神经损伤的迹象，包括29只眼苍白、8只眼相对传入性瞳孔障碍和2只眼视乳头内出血。
NAION可能在玻璃体切除术后发生。玻璃体切除术后的“视野缺损”很常见，许多受累眼表现出视神经损伤的证据，其中一些可能代表NAION。
