Stopa Marcin, Kociecki Jarosław
Department of Ophthalmology, Poznan University of Medical Sciences, Poznan, Poland.
Eur J Ophthalmol. 2011 Jul-Aug;21(4):468-72. doi: 10.5301/EJO.2010.6069.
To investigate the anatomy and function of the macula in patients after retinectomy for retinal detachment complicated by proliferative vitreoretinopathy (PVR) grade C.
A prospective study involving 25 patients operated with vitrectomy and retinectomy due to retinal detachment complicated by PVR grade C. Outcome measures included preoperative and postoperative best-corrected visual acuity (BCVA) at 6 months and the difference between preoperative and postoperative BCVA. Furthermore, the macular status was analyzed on postoperative optical coherence tomography (OCT) scans.
Reattachment was observed in 96% (24/25) of patients. Median BCVA improved from 2.30 logMAR (range 1.00 to 2.69 logMAR) to 1.00 logMAR (range 0.38 to 2.90 logMAR). The change from preoperative visual acuity was statistically significant (p=0.0003, Wilcoxon signed rank test). Macular status with pathologies was observed in 75% of eyes on OCT (retinal pigment epithelium irregularities 37.5%, cystoid macular edema 33%, epiretinal membrane 8.3%, subretinal fluid 4%, and subretinal perfluorocarbon liquid 4%). These eyes had significantly worse final visual acuity (p=0.01, Wilcoxon rank sum test) compared to those with a clinically normal macula. The retinectomy size influenced neither visual acuity (p=0.06, Wilcoxon rank sum test) nor incidence of normal macular status (p=0.14, Fisher exact test).
Even though retinectomy is an effective technique to reattach the retina in complicated cases of retinal detachment, the functional outcome was found to be influenced by abnormal macular status, observed in 75% of eyes. Moreover, 360-degree retinectomies did not show different anatomic or functional results vs subtotal ones.
研究视网膜脱离合并C级增殖性玻璃体视网膜病变（PVR）患者行视网膜切除术后黄斑的解剖结构和功能。
一项前瞻性研究，纳入25例因视网膜脱离合并C级PVR而接受玻璃体切除术和视网膜切除术的患者。观察指标包括术前及术后6个月的最佳矫正视力（BCVA），以及术前和术后BCVA的差值。此外，对术后光学相干断层扫描（OCT）图像进行黄斑状态分析。
96%（24/25）的患者视网膜复位。BCVA中位数从2.30 logMAR（范围1.00至2.69 logMAR）提高到1.00 logMAR（范围0.38至2.90 logMAR）。术前和术后视力变化具有统计学意义（p = 0.0003，Wilcoxon符号秩和检验）。OCT检查发现75%的患眼黄斑存在病变（视网膜色素上皮不规则37.5%，黄斑囊样水肿33%，视网膜前膜8.3%，视网膜下液4%，视网膜下全氟碳液体4%）。与黄斑临床正常的患眼相比，这些患眼的最终视力明显更差（p = 0.01，Wilcoxon秩和检验）。视网膜切除范围对视力（p = 0.06，Wilcoxon秩和检验）和黄斑正常状态的发生率（p = 0.14，Fisher确切概率检验）均无影响。
尽管视网膜切除术是复杂视网膜脱离病例中使视网膜复位的有效技术，但发现75%的患眼黄斑状态异常会影响功能预后。此外，360度视网膜切除术与次全视网膜切除术相比，在解剖或功能结果上并无差异。
