Yeh Po-Ting, Cheng Cheng-Kuo, Chen Muh-Shy, Yang Chang-Hao, Yang Chung-May
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Retina. 2009 Mar;29(3):355-61. doi: 10.1097/IAE.0b013e31818c3251.
To report clinical characteristics and treatment results of macular hole (MH) with diabetic fibrovascular proliferation.
Twenty-three eyes of 23 consecutive patients having surgery for diabetic fibrovascular proliferation and MH were reviewed. Macular hole closure and final visual acuity were examined in relation to clinical characteristics.
Traction and combined retinal detachment was seen in 17 cases and 6 cases, respectively. Four cases had internal limiting membrane (ILM) peeling. Macular hole was closed in 19 cases (82.6%) after surgery. Thickened fibrovascular proliferation with vitreomacular adhesion at or close to the MH edge was found in most cases. Of the 5 cases of shallow macular detachment, 2 cases without ILM peeling had persistent hole; 3 cases with ILM peeling had MH closure. Of the other 18 cases, only 2 of the 17 cases without ILM peeling had persistent hole (P = 0.64). Multiple regression analysis revealed preoperation visual acuity and degree of macular elevation were associated with postoperation visual acuity.
Unique vitreomacular features exist in diabetic fibrovascular proliferation and MH. Internal limiting membrane peeling does not seem to significantly affect MH closure in cases with moderate or high macular detachment. Final vision may be associated with preoperative visual acuity and degree of macular elevation.
报告伴有糖尿病性纤维血管增殖的黄斑裂孔（MH）的临床特征及治疗结果。
回顾性分析连续23例因糖尿病性纤维血管增殖和MH接受手术的患者的23只眼。根据临床特征检查黄斑裂孔闭合情况及最终视力。
分别有17例和6例出现牵拉性视网膜脱离和合并性视网膜脱离。4例进行了内界膜（ILM）剥除术。术后19例（82.6%）黄斑裂孔闭合。多数病例在MH边缘或其附近发现增厚的纤维血管增殖伴有玻璃体黄斑粘连。在5例黄斑浅脱离病例中，2例未行ILM剥除术的患者裂孔持续存在；3例行ILM剥除术的患者MH闭合。在其他18例中，17例未行ILM剥除术的患者中只有2例裂孔持续存在（P = 0.64）。多元回归分析显示术前视力和黄斑抬高程度与术后视力相关。
糖尿病性纤维血管增殖和MH存在独特的玻璃体黄斑特征。在中度或高度黄斑脱离的病例中，内界膜剥除似乎对MH闭合没有显著影响。最终视力可能与术前视力和黄斑抬高程度有关。
