Shimonagano Yuka, Makiuchi Reiko, Miyazaki Miho, Doi Norihito, Uemura Akinori, Sakamoto Taiji
Department of Ophthalmology, Faculty of Medicine, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan.
Jpn J Ophthalmol. 2007 May-Jun;51(3):204-9. doi: 10.1007/s10384-007-0423-8. Epub 2007 Jun 7.
To report results of an investigation of visual acuity (VA) and foveal thickness in diabetic macular edema (DME) patients after vitrectomy.
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.
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).
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.
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。
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。
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)。
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。