Ma Jin, Yao Ke, Zhang Zheng, Tang Xiajing
Eye Center of Affiliated Second Hospital School of Medicine, Zhejiang University, Hangzhou, PR China.
Retina. 2008 Jul-Aug;28(7):947-56. doi: 10.1097/IAE.0b013e31816c683d.
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).
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.
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).
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.
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。
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。
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)。
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。