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视网膜脱离玻璃体切割术后光感受器外节的修复。

Restoration of photoreceptor outer segment after vitrectomy for retinal detachment.

机构信息

Department of Ophthalmology, Gunma University School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, Japan.

出版信息

Am J Ophthalmol. 2010 Feb;149(2):284-90. doi: 10.1016/j.ajo.2009.08.025. Epub 2009 Nov 25.

Abstract

PURPOSE

To report photoreceptor restoration and visual outcomes after vitrectomy for retinal detachment.

DESIGN

Retrospective, observational case series.

METHODS

We prospectively studied the tomographic features of reattached retinas in 20 eyes with a macula-off rhegmatogenous retinal detachment using spectral-domain optical coherence tomography 1, 3, and 6 months after 3-port vitrectomy with SF(6) gas tamponade. All eyes were examined more than 3 months after surgery.

RESULTS

The optical coherence tomography foveal findings were classified as a disrupted inner segment and outer segment (IS/OS) line, a residual foveal detachment, and a continuous IS/OS line. A disrupted IS/OS line was seen in 11 eyes (55%) at 1 month and in 8 eyes (40%) at 3 months, a foveal detachment was seen in 8 eyes (40%) at 1 month and in 7 eyes (35%) at 3 months, and a continuous IS/OS line was seen in 1 eye (5%) at 1 month and in 5 eyes (25%) at 3 months. In 18 eyes followed up for 6 months, optical coherence tomography showed a disrupted IS/OS line in 3 eyes (17%), a foveal detachment in 6 eyes (33%), and a continuous IS/OS line in 9 eyes (50%). The mean best-corrected visual acuities at 1 and 6 months were 0.26 and 0.16 with a disrupted IS/OS line, 0.60 and 0.95 with a foveal detachment, and 0.8 and 0.95 with a continuous IS/OS line. The mean best-corrected visual acuity was significantly (P < .0001) lower with a disrupted IS/OS line compared with the other formations at 6 months.

CONCLUSIONS

The IS/OS line at the fovea recovered gradually after surgery. The postoperative visual acuity was correlated with a restored IS/OS line.

摘要

目的

报告玻璃体切割治疗视网膜脱离后光感受器的恢复和视力结果。

设计

回顾性、观察性病例系列。

方法

我们前瞻性地研究了 20 只黄斑脱离的孔源性视网膜脱离眼,在 3 端口玻璃体切除术后 1、3 和 6 个月,使用频域光学相干断层扫描(OCT)检查,SF(6)气体填充。所有眼均在手术后 3 个月以上进行检查。

结果

OCT 黄斑区结果分为内节和外节(IS/OS)线中断、黄斑区残余脱离和 IS/OS 线连续。1 个月时,11 只眼(55%)出现 IS/OS 线中断,3 个月时 8 只眼(40%)出现 IS/OS 线中断;1 个月时 8 只眼(40%)出现黄斑区脱离,3 个月时 7 只眼(35%)出现黄斑区脱离;1 个月时 1 只眼(5%)出现 IS/OS 线连续,3 个月时 5 只眼(25%)出现 IS/OS 线连续。在 18 只随访 6 个月的眼中,OCT 显示 3 只眼(17%)出现 IS/OS 线中断,6 只眼(33%)出现黄斑区脱离,9 只眼(50%)出现 IS/OS 线连续。IS/OS 线中断者术后 1 个月和 6 个月最佳矫正视力分别为 0.26 和 0.16,黄斑区脱离者分别为 0.60 和 0.95,IS/OS 线连续者分别为 0.8 和 0.95。与其他结构相比,6 个月时 IS/OS 线中断者最佳矫正视力明显(P<0.0001)较低。

结论

手术后黄斑区的 IS/OS 线逐渐恢复。术后视力与 IS/OS 线恢复有关。

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