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25G玻璃体切除术联合曲安奈德辅助内界膜剥除治疗视网膜分支静脉阻塞相关的慢性黄斑囊样水肿

25-gauge vitrectomy and triamcinolone acetonide-assisted internal limiting membrane peeling for chronic cystoid macular edema associated with branch retinal vein occlusion.

作者信息

Ma Jin, Yao Ke, Zhang Zheng, Tang Xiajing

机构信息

Eye Center of Affiliated Second Hospital School of Medicine, Zhejiang University, Hangzhou, PR China.

出版信息

Retina. 2008 Jul-Aug;28(7):947-56. doi: 10.1097/IAE.0b013e31816c683d.

Abstract

PURPOSE

To evaluate the efficacy of 25-gauge vitrectomy and triamcinolone acetonide (TA)-assisted internal limiting membrane (ILM) peeling for chronic cystoid macular edema (CCME) in branch retinal vein occlusion (BRVO).

METHODS

Thirty-four patients (38 eyes) presenting with CCME in BRVO were treated prospectively by 25-gauge vitrectomy and ILM peeling. Change in best-corrected visual acuity (BCVA) and CCME status were evaluated preoperatively and postoperatively at 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, and 7 months.

RESULTS

Mean postoperative logMAR BCVAs +/- SD were 0.69 +/- 0.42, 0.65 +/- 0.41, 0.59 +/- 0.32, 0.39 +/- 0.27, 0.35 +/- 0.31, 0.32 +/- 0.28, and 0.32 +/- 0.31 at the seven follow-up months, respectively. Mean foveal thicknesses +/- SD were 443 +/- 60 microm, 212 +/- 67 microm, 188 +/- 41 microm, 176 +/- 53 microm, 173 +/- 41 microm, 171 +/- 39 microm, and 170 +/- 41 microm at the 7 follow-up months, respectively. Compared with before surgery, BCVA improved, and CCME was absorbed significantly (P < 0.01, Dunnett test). Foveal thickness and logMAR BCVA 7 months after surgery had a significant negative linear correlation (r = -0.81, P < 0.01; Spearman rank correlation).

CONCLUSIONS

Twenty-five-gauge vitrectomy with TA-assisted ILM peeling is generally effective in reducing macular edema and improving BCVA for CCME in BRVO for at least 7 months.

摘要

目的

评估25G玻璃体切除术联合曲安奈德(TA)辅助内界膜(ILM)剥除术治疗视网膜分支静脉阻塞(BRVO)所致慢性黄斑囊样水肿(CCME)的疗效。

方法

对34例(38只眼)BRVO合并CCME患者进行前瞻性研究,采用25G玻璃体切除术及ILM剥除术治疗。分别于术前及术后1个月、2个月、3个月、4个月、5个月、6个月和7个月评估最佳矫正视力(BCVA)变化及CCME状态。

结果

术后7个月随访时,平均logMAR BCVA±标准差分别为0.69±0.42、0.65±0.41、0.59±0.32、0.39±0.27、0.35±0.31、0.32±0.28和0.32±0.31。术后7个月随访时,平均黄斑中心凹厚度±标准差分别为443±60μm、212±67μm、188±41μm、176±53μm、173±41μm、171±39μm和170±41μm。与手术前相比,BCVA提高,CCME明显吸收(P<0.01,Dunnett检验)。术后7个月黄斑中心凹厚度与logMAR BCVA呈显著负线性相关(r=-0.81,P<0.01;Spearman等级相关)。

结论

25G玻璃体切除术联合TA辅助ILM剥除术在减轻BRVO所致CCME的黄斑水肿及改善BCVA方面通常至少7个月有效。

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