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玻璃体切除术后糖尿病性黄斑水肿的视力及黄斑中心凹厚度结果。

Results of visual acuity and foveal thickness in diabetic macular edema after vitrectomy.

作者信息

Shimonagano Yuka, Makiuchi Reiko, Miyazaki Miho, Doi Norihito, Uemura Akinori, Sakamoto Taiji

机构信息

Department of Ophthalmology, Faculty of Medicine, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan.

出版信息

Jpn J Ophthalmol. 2007 May-Jun;51(3):204-9. doi: 10.1007/s10384-007-0423-8. Epub 2007 Jun 7.

Abstract

PURPOSE

To report results of an investigation of visual acuity (VA) and foveal thickness in diabetic macular edema (DME) patients after vitrectomy.

METHODS

A retrospective study was performed of the records of 47 patients (61 eyes) who received pars plana vitrectomy (PPV) for DME. All eyes were followed up for over 6 months (mean, 24.8 months; range, 6-60 months). VA and foveal thickness evaluated by optical coherence tomography were reviewed preoperatively and postoperatively.

RESULTS

Twenty-four-month follow-up data were available for 46 of the 61 eyes (75%). VA at the final examination had improved by 0.2 log units or more in 34 of the 61 eyes (56%), remained unchanged in 21 eyes (34%), and worsened in six eyes (10%). Mean foveal thickness decreased by more than 20% of the preoperative value in 50 of the 61 eyes (82%), remained unchanged in ten eyes (16%), and increased by more than 20% in one eye (2%) at the final examination. Postoperative best-corrected visual acuity (BCVA) at both 12 and 24 months was significantly better than preoperative BCVA (P < 0.0001). Foveal thickness at 3 months or later significantly decreased from the preoperative value (P < 0.0001), but remained unchanged in comparison with postoperative 12 months and 24 months values (P = 0.19). Preoperative VA and presence of cystoid macular edema (CME) were independently associated with final visual acuity (P = 0.001).

CONCLUSIONS

PPV for DME effectively improved VA and reduced foveal thickness for a longer postoperative period. Better preoperative VA was associated with better final postoperative VA. The eyes without CME tended to have better final postoperative VA.

摘要

目的

报告糖尿病性黄斑水肿(DME)患者玻璃体切除术后视力(VA)和黄斑中心凹厚度的调查结果。

方法

对47例(61只眼)因DME接受玻璃体切除术(PPV)的患者记录进行回顾性研究。所有眼睛均随访超过6个月(平均24.8个月;范围6 - 60个月)。回顾术前和术后通过光学相干断层扫描评估的VA和黄斑中心凹厚度。

结果

61只眼中46只眼(75%)有24个月的随访数据。61只眼中34只眼(56%)在最终检查时视力提高了0.2对数单位或更多,21只眼(34%)视力保持不变,6只眼(10%)视力恶化。61只眼中50只眼(82%)在最终检查时黄斑中心凹平均厚度比术前值降低了20%以上,10只眼(16%)保持不变,1只眼(2%)增加了20%以上。术后12个月和24个月的最佳矫正视力(BCVA)均显著优于术前BCVA(P < 0.0001)。3个月及以后的黄斑中心凹厚度较术前值显著降低(P < 0.0001),但与术后12个月和24个月的值相比无变化(P = 0.19)。术前视力和黄斑囊样水肿(CME)的存在与最终视力独立相关(P = 0.001)。

结论

DME的PPV在术后较长时间内有效改善了视力并降低了黄斑中心凹厚度。术前视力较好与术后最终视力较好相关。无CME的眼睛术后最终视力往往较好。

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