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睫状体平坦部玻璃体切割术后视网膜脱离相关脉络膜缺损的光相干断层扫描。

Optical coherence tomography after pars plana vitrectomy for retinal detachment related to choroidal coloboma.

机构信息

Department of Ophthalmology, Ege University Hospital, Izmir, Turkey.

出版信息

Retina. 2010 Jul-Aug;30(7):1078-83. doi: 10.1097/IAE.0b013e3181ce1736.

Abstract

PURPOSE

The purpose was to study the anatomical outcome of choroidal coloboma with retinal detachment managed by pars plana vitrectomy with silicone oil tamponade using optical coherence tomography.

METHODS

Six eyes of six patients with retinal detachment related to choroidal coloboma underwent pars plana vitrectomy with internal tamponade using silicone oil. Pre- and postoperative best-corrected visual acuities, intraocular pressure measurements, and intra- and postoperative complications were obtained. Color fundus photographs and optical coherence tomography images were taken at each follow-up.

RESULTS

Patients were observed up to a mean of 14 months (range, 8-18 months). Silicone oil was removed in all eyes. In all patients who had undergone vitrectomy, the retina was completely reattached before and after silicone oil extraction. Postoperatively, best-corrected visual acuities improved in 5 patients and remained unchanged in 1 patient ranging from 20/200 to 20/40 at the last follow-up. Although the retina was reattached in all patients, the optical coherence tomography showed a persistent intercalary membrane detachment in 4 patients (67%). In 1 patient (16%), subclinical retinal detachment that did not increase during the follow-up after silicone oil removal was detected just beyond the margin of the coloboma.

CONCLUSION

After vitrectomy and silicone oil removal, optical coherence tomography showed persistent detachment of the intercalary membrane in most patients. These findings emphasize the importance of sealing the junction between the intercalary membrane and extracolobomatous retina with a laser barrier.

摘要

目的

本研究旨在通过光相干断层扫描(OCT)观察硅油眼内填充下经睫状体平坦部玻璃体切除术治疗脉络膜视网膜缺损伴视网膜脱离的解剖学结果。

方法

对 6 例(6 眼)与脉络膜视网膜缺损相关的视网膜脱离患者行睫状体平坦部玻璃体切除术联合硅油内填充。记录术前及术后最佳矫正视力、眼压测量值及术中术后并发症。每次随访时均行眼底彩色照相和 OCT 检查。

结果

患者平均随访 14 个月(8~18 个月)。所有眼均行硅油取出术。所有行玻璃体切除术的患者在硅油取出前后视网膜均完全复位。术后 5 例患者最佳矫正视力提高,1 例患者保持不变,最佳矫正视力从术前的 20/200 提高至术后的 20/40。虽然所有患者的视网膜均复位,但 OCT 显示 4 例(67%)患者存在持续性间插膜脱离。在 1 例患者(16%)中,硅油取出后随访期间虽未发现视网膜脱离增加,但在视网膜缺损边缘以外发现亚临床视网膜脱离。

结论

玻璃体切除联合硅油取出后,OCT 显示大多数患者间插膜仍存在持续性脱离。这些发现强调了用激光屏障封闭间插膜与视网膜外缺损交界处的重要性。

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