Department of Ophthalmology, Kyungpook National University, Chung-Gu, Taegu, South Korea.
Retina. 2010 Jan;30(1):117-24. doi: 10.1097/IAE.0b013e3181bced68.
The purpose of this study was to evaluate the long-term effects of vitrectomy and internal limiting membrane peeling for macular edema secondary to central retinal vein occlusion (CRVO) and hemiretinal vein occlusion (HRVO).
Best-corrected visual acuity, central foveal thickness by optical coherence tomography, and fluorescein angiography were evaluated retrospectively in 20 patients (20 eyes). The mean follow-up time was 61.2 months. Pars plana vitrectomy and internal limiting membrane peeling using indocyanine green staining were performed in all patients.
Preoperative mean central foveal thickness of all 20 eyes decreased significantly by 6 months, and this reduction was maintained until 60 months. The mean central foveal thickness of the group with perfused type CRVO, ischemic type CRVO, and HRVO at 6 months significantly decreased from the preoperative value, and the significant reduction was maintained until 60 months. Best-corrected visual acuity of the perfused CRVO and HRVO groups tended to improve in contrast to the ischemic CRVO group postoperatively. Best-corrected visual acuity of the perfused CRVO group at 24 months or later was significantly improved from preoperative best-corrected visual acuity.
Pars plana vitrectomy with internal limiting membrane peeling in eyes with macular edema secondary to CRVO and HRVO produces an anatomical improvement, which persists up to 5 years, and a best-corrected visual acuity improvement, at least in perfused CRVO and HRVO.
本研究旨在评估玻璃体切割联合内界膜剥除治疗视网膜中央静脉阻塞(CRVO)和半侧视网膜静脉阻塞(HRVO)继发黄斑水肿的长期疗效。
回顾性分析 20 例(20 只眼)患者的最佳矫正视力、光学相干断层扫描(OCT)测量的中心黄斑区视网膜厚度和荧光素眼底血管造影(FFA)资料。平均随访时间为 61.2 个月。所有患者均行标准经睫状体平坦部玻璃体切割联合内界膜剥除术,术中使用吲哚菁绿(ICG)染色。
所有 20 只眼术前平均中心黄斑区视网膜厚度在术后 6 个月时显著下降,且这种降低一直持续到 60 个月。灌注型 CRVO、缺血型 CRVO 和 HRVO 组在术后 6 个月时的平均中心黄斑区视网膜厚度较术前明显下降,且这种显著下降一直持续到 60 个月。与缺血型 CRVO 组相比,灌注型 CRVO 和 HRVO 组术后的最佳矫正视力有改善的趋势。灌注型 CRVO 组在术后 24 个月或以后的最佳矫正视力明显高于术前最佳矫正视力。
CRVO 和 HRVO 继发黄斑水肿患者行玻璃体切割联合内界膜剥除术可改善解剖结构,这种改善至少可维持 5 年,同时可改善最佳矫正视力,至少在灌注型 CRVO 和 HRVO 中如此。