Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Acta Ophthalmol. 2011 Mar;89(2):172-8. doi: 10.1111/j.1755-3768.2009.01649.x.
This study aimed to evaluate treatment effects of intravitreal gas for macular hole with localized retinal detachment (RD) in highly myopic eyes and to examine how the vitreomacular relationship and other factors may influence treatment outcomes.
Twenty highly myopic patients with macular holes and localized posterior RD, treated initially with intravitreal injection of C(3) F(8) , were prospectively studied. Recurrent disease was treated with repeated gas injection or vitrectomy according to the extent of detachment. Length of follow-up was ≥ 12 months. Vitreomacular conditions were determined before and within 2 months after gas injection by standard optical coherence tomography. Demographics, refractive errors, axial length, the extent of chorioretinal (CR) atrophy and visual acuity were recorded.
The success rate after primary gas injection was 70%. The remaining 30% of patients achieved anatomic success after further treatment, including vitrectomy with gas or silicone oil tamponade and/or scleral buckling. All cases achieved anatomic success after a mean of 1.4 surgeries. Univariate analysis showed that the patterns of the posterior vitreoretinal relationship did not differ significantly between those successfully treated with gas only (group 1) and those requiring vitrectomy (group 2) (p = 1.000). Logistic regression showed no statistically significant differences in any characteristics between groups 1 and 2.
Intravitreal gas tamponade alone may achieve anatomic success in more than two-thirds of highly myopic patients with macular holes and localized RD. Patients with different clinical characteristics and vitreoretinal relationships seem to have similar opportunities to achieve reattachment through this relatively non-invasive surgery.
本研究旨在评估对于高度近视伴局限性视网膜脱离的黄斑裂孔患者行玻璃体腔注气治疗的效果，并探讨玻璃体黄斑关系及其他因素对治疗结果的影响。
前瞻性研究 20 例黄斑裂孔伴局限性后部 RD 的高度近视患者，最初采用玻璃体腔注射 C(3)F(8)治疗。根据脱离范围，采用反复注气或玻璃体切割术治疗复发性疾病。随访时间≥12 个月。在注气前和注气后 2 个月内，采用标准光学相干断层扫描评估玻璃体黄斑情况。记录患者的人口统计学、屈光不正、眼轴长度、脉络膜视网膜萎缩（CR）程度和视力。
初次注气后成功率为 70%。其余 30%的患者经进一步治疗（包括玻璃体切割联合气/硅油填充和/或巩膜扣带术）后获得解剖学成功。所有患者平均行 1.4 次手术后均获得解剖学成功。单因素分析显示，仅接受注气治疗（第 1 组）和需要玻璃体切割治疗（第 2 组）的患者的后玻璃体视网膜关系模式无显著差异（p=1.000）。Logistic 回归分析显示，第 1 组和第 2 组之间在任何特征方面均无统计学差异。
玻璃体腔注气单独治疗可使超过三分之二的高度近视伴黄斑裂孔和局限性 RD 患者获得解剖学成功。具有不同临床特征和玻璃体视网膜关系的患者似乎通过这种相对非侵入性手术获得再附着的机会相似。
