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黄斑转位术能否成为治疗黄斑下脉络膜新生血管膜的理想方法?

Can macular translocation be a satisfactory management of subfoveal choroidal neovascular membrane?

作者信息

Bereczki Arpád, Bíró Zsolt

机构信息

"Petz Aladár" County Teaching Hospital, Department of Ophthalmology, 9002. Gy r, Vasvári Pál u. 2, Hungary.

出版信息

Clin Ophthalmol. 2008 Jun;2(2):447-50.

PMID:19668735
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2693980/
Abstract

PURPOSE

To report histopathological observations regarding one of our macular translocation cases.

METHODS

We have performed macular translocation with 360 degree retinotomy since 1997, and limited macular translocation with or without subretinal membrane removal since 2002. One of our patients died on the fifth postoperative day, so extensive histological examination of the removed neovascular membrane and entire globe was performed.

RESULTS

We found that pigment epithelium remained attached to the neurosensory retina during retinal separation, in which case the rotated fovea will be relocated in a partially devoided pigment epithelial zone. In addition, even after complete surgical removal of the membrane during macular translocation, large membrane remnants are still detectable by histological examination.

CONCLUSION

In our opinion, macular translocation is not a satisfactory management of subfoveal neovascular membranes, because of changes in the pigment epithelium during surgery, and large subretinal neovascular membrane remnants.

摘要

目的

报告我们其中一例黄斑转位病例的组织病理学观察结果。

方法

自1997年起我们进行了360度视网膜切开的黄斑转位手术,自2002年起进行了有或没有视网膜下膜切除的局限性黄斑转位手术。我们的一名患者在术后第五天死亡,因此对切除的新生血管膜和整个眼球进行了广泛的组织学检查。

结果

我们发现,在视网膜分离过程中色素上皮仍附着于神经感觉视网膜,在这种情况下,旋转后的中央凹将重新定位在部分缺乏色素上皮的区域。此外,即使在黄斑转位手术中完全手术切除膜后,组织学检查仍可检测到大量膜残留。

结论

我们认为,黄斑转位不是治疗黄斑下新生血管膜的理想方法,原因是手术过程中色素上皮发生变化,以及视网膜下新生血管膜大量残留。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/198e/2693980/08b809ae6c16/co-2-447f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/198e/2693980/b869363e6f7c/co-2-447f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/198e/2693980/8e256e0d74f8/co-2-447f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/198e/2693980/08b809ae6c16/co-2-447f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/198e/2693980/b869363e6f7c/co-2-447f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/198e/2693980/8e256e0d74f8/co-2-447f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/198e/2693980/08b809ae6c16/co-2-447f3.jpg

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本文引用的文献

1
Long-term results of submacular surgery combined with macular translocation of the retinal pigment epithelium in neovascular age-related macular degeneration.黄斑下手术联合视网膜色素上皮黄斑转位术治疗新生血管性年龄相关性黄斑变性的长期结果
Ophthalmology. 2005 Dec;112(12):2081-7. doi: 10.1016/j.ophtha.2005.06.029.
2
Macular translocation in a patient with adult-onset foveomacular vitelliform dystrophy with light- and electron-microscopic observations on the surgically removed subfoveal tissue.成年发病的中心凹黄斑卵黄样营养不良患者的黄斑转位,并对手术切除的中心凹下组织进行光镜和电镜观察
Graefes Arch Clin Exp Ophthalmol. 2004 Jun;242(6):456-67. doi: 10.1007/s00417-004-0922-y. Epub 2004 May 11.
3
One year follow up of macular translocation with 360 degree retinotomy in patients with age related macular degeneration.
年龄相关性黄斑变性患者行360度视网膜切开术黄斑转位术的一年随访
Br J Ophthalmol. 2003 May;87(5):615-21. doi: 10.1136/bjo.87.5.615.
4
Retinal translocation and photodynamic therapy for age-related macular degeneration with classic choroidal neovascularization: a clinicopathologic case report.
Retina. 2002 Dec;22(6):818-24. doi: 10.1097/00006982-200212000-00027.
5
Macular translocation in nonexudative age-related macular degeneration.非渗出性年龄相关性黄斑变性中的黄斑转位术
Retina. 2002 Dec;22(6):786-94. doi: 10.1097/00006982-200212000-00017.
6
Macular translocation with 360 degree retinotomy for management of age-related macular degeneration with subfoveal choroidal neovascularization.采用360度视网膜切开术的黄斑转位术治疗伴有黄斑下脉络膜新生血管的年龄相关性黄斑变性。
Am J Ophthalmol. 2002 Oct;134(4):560-5. doi: 10.1016/s0002-9394(02)01641-0.
7
Macular translocation: unifying concepts, terminology, and classification.黄斑转位术:统一概念、术语和分类
Am J Ophthalmol. 2001 Feb;131(2):244-53. doi: 10.1016/s0002-9394(00)00788-1.
8
Histological examination of the pigment epithelium-Bruch membrane-chorio-capillaris complex after macular translocation.黄斑转位术后色素上皮-布鲁赫膜-脉络膜毛细血管复合体的组织学检查。
Br J Ophthalmol. 2000 May;84(5):550-1. doi: 10.1136/bjo.84.5.546f.
9
Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials--TAP report. Treatment of age-related macular degeneration with photodynamic therapy (TAP) Study Group.维替泊芬光动力疗法治疗年龄相关性黄斑变性的中心凹下脉络膜新生血管:两项随机临床试验的一年结果——TAP报告。年龄相关性黄斑变性光动力疗法(TAP)研究组
Arch Ophthalmol. 1999 Oct;117(10):1329-45.
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