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家族性渗出性玻璃体视网膜病变相关的孔源性视网膜脱离的临床特征和手术治疗。

Clinical characteristics and surgical management of familial exudative vitreoretinopathy-associated rhegmatogenous retinal detachment.

机构信息

Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan.

出版信息

Retina. 2012 Feb;32(2):220-5. doi: 10.1097/IAE.0b013e31821c3ec5.

Abstract

PURPOSE

The purpose of this study was to report the clinical characteristics and surgical outcome of familial exudative vitreoretinopathy-associated rhegmatogenous retinal detachment.

METHODS

Retrospective interventional case series of patients with familial exudative vitreoretinopathy-associated rhegmatogenous retinal detachment. All cases had preoperative and postoperative clinical evaluations. Eyes were divided into three groups: no, moderate, and severe foveal dragging according to the status of fovea. Scleral buckling procedures or vitrectomy was performed to attach the retina.

RESULTS

Twenty-four eyes in 22 patients were included in this study. The male to female ratio was 18:4. The average age was 16.42 ± 5.48 years. There were 14, 5, and 5 eyes in the no, moderate, and severe foveal dragging groups, respectively. Proliferative vitreoretinopathy was present in only one eye in the severe foveal dragging group. In the subgroup of eyes without foveal dragging, neither proliferative vitreoretinopathy, posterior located breaks, nor giant tears were noted. All eyes needed only scleral buckle to reattach the retina. In the subgroup with moderate foveal dragging, posterior located break was noted in one eye, which was the only eye in this group that needed vitrectomy besides scleral buckle to attach the retina. In eyes with severe foveal dragging, Stage D proliferative vitreoretinopathy was noted in one eye and posterior located break in one eye. Encircling buckle and vitrectomy were necessary in all eyes. The average number of operation is 1.1, 1.2, and 2.4 for each of the three groups, respectively. Final visual acuity improved in 23 of 24 eyes. Final retinal attachment was obtained in 95.8% of eyes (23 of 24).

CONCLUSION

Male predominance and juvenile onset are the main characteristics in familial exudative vitreoretinopathy-associated rhegmatogenous retinal detachment. Surgical success rates are comparable to rhegmatogenous retinal detachment unassociated with familial exudative vitreoretinopathy in cases without severe foveal dragging and are worse in the group with severe foveal dragging.

摘要

目的

本研究旨在报告家族性渗出性玻璃体视网膜病变相关性孔源性视网膜脱离的临床特征和手术结果。

方法

回顾性分析家族性渗出性玻璃体视网膜病变相关性孔源性视网膜脱离患者的病例系列。所有病例均进行术前和术后临床评估。根据黄斑区视网膜的情况将眼分为无、中度和重度黄斑区牵拉三组。行巩膜扣带术或玻璃体切除术以复位视网膜。

结果

本研究共纳入 22 例患者的 24 只眼。男女比例为 18:4。平均年龄为 16.42±5.48 岁。无、中度和重度黄斑区牵拉组分别有 14、5 和 5 只眼。仅 1 只重度黄斑区牵拉组的眼存在增生性玻璃体视网膜病变。在无黄斑区牵拉的亚组中,既没有发现增生性玻璃体视网膜病变、后极部裂孔,也没有发现巨大裂孔。所有眼仅需要巩膜扣带即可复位视网膜。在中度黄斑区牵拉的亚组中,1 只眼存在后极部裂孔,该眼是该组中唯一需要除巩膜扣带外还需要玻璃体切除术复位视网膜的眼。在重度黄斑区牵拉的眼中,1 只眼存在 D 期增生性玻璃体视网膜病变,1 只眼存在后极部裂孔。所有眼均需要环扎带和玻璃体切除术。三组的平均手术次数分别为 1.1、1.2 和 2.4。24 只眼中的 23 只视力提高。95.8%(23 只眼)的眼最终视网膜贴附成功。

结论

家族性渗出性玻璃体视网膜病变相关性孔源性视网膜脱离以男性为主,发病年龄早。在无重度黄斑区牵拉的病例中,手术成功率与非家族性渗出性玻璃体视网膜病变相关性孔源性视网膜脱离相当,而在重度黄斑区牵拉的病例中,手术成功率较差。

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