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星状玻璃体病变患者眼内玻璃体视网膜界面的解剖学发现。

Anatomical findings of vitreoretinal interface in eyes with asteroid hyalosis.

作者信息

Mochizuki Yasutaka, Hata Yasuaki, Kita Takeshi, Kohno Ri-Ichiro, Hasegawa Yuhei, Kawahara Shuhei, Arita Ryoichi, Ishibashi Tatsuro

机构信息

Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2009 Sep;247(9):1173-7. doi: 10.1007/s00417-009-1095-5. Epub 2009 May 7.

Abstract

PURPOSE

To investigate the anatomical features of vitreoretinal interface in eyes with asteroid hyalosis (AH) with optical coherence tomography (OCT) and intravitreal triamcinolone acetonide (TA) during vitreous surgery.

METHODS

This study was an interventional clinical case series. Records relating to ten eyes from ten patients who underwent a TA-assisted vitrectomy for the treatment of diverse vitreoretinal diseases complicated with AH. The posterior vitreoretinal interface was examined by preoperative OCT and by intraoperative visualization of posterior vitreous cortex utilizing TA.

RESULTS

In eight of ten AH eyes, preoperative OCT revealed abnormal vitreoretinal adhesions. In four of these eight eyes, posterior vitreoschisis could be seen on OCT. In the other four of these eight eyes, a clear no posterior vitreous detachment (PVD) pattern could be seen on OCT. Although posterior vitreous cortex could not be clearly identified with preoperative OCT in two of ten AH eyes, a complete PVD was refuted by intraoperative visualization of the posterior vitreous cortex with TA identical to the other eight eyes.

CONCLUSION

These results indicate that complete PVD appears to be unlikely to occur in eyes with AH. In addition, spontaneous PVD in eyes with AH might lead to vitreoschisis or residual whole layer or posterior vitreous cortex, possibly due to anomalous vitreoretinal adhesion.

摘要

目的

利用光学相干断层扫描(OCT)和玻璃体手术中玻璃体内注射曲安奈德(TA),研究星状玻璃体病变(AH)患者玻璃体视网膜界面的解剖特征。

方法

本研究为一项介入性临床病例系列研究。记录了10例患者的10只眼睛,这些患者接受了TA辅助玻璃体切除术,以治疗合并AH的各种玻璃体视网膜疾病。术前通过OCT检查玻璃体视网膜后界面,并在术中利用TA观察玻璃体后皮质。

结果

在10只AH眼中的8只,术前OCT显示玻璃体视网膜粘连异常。在这8只眼中的4只,OCT上可见玻璃体后脱离。在这8只眼中的另外4只,OCT上可见清晰的无玻璃体后脱离(PVD)模式。虽然在10只AH眼中的2只,术前OCT无法清晰识别玻璃体后皮质,但术中用TA观察玻璃体后皮质显示与其他8只眼一样,不存在完全性PVD。

结论

这些结果表明,AH患者似乎不太可能发生完全性PVD。此外,AH患者的自发性PVD可能导致玻璃体后脱离或残留全层或玻璃体后皮质,可能是由于玻璃体视网膜粘连异常所致。

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