Cho Minhee, D'Amico Donald J
Weill Cornell Medical College, Department of Ophthalmology, New York, NY, USA.
Clin Ophthalmol. 2012;6:981-9. doi: 10.2147/OPTH.S33391. Epub 2012 Jul 6.
The purpose of this study was to investigate the visual and anatomic outcomes in patients with chronic macular edema who underwent 25-gauge pars plana vitrectomy with internal limiting membrane peeling.
This study was a retrospective chart review of 24 eyes from 21 patients who underwent 25-gauge pars plana vitrectomy and indocyanine green-assisted internal limiting membrane peeling for chronic macular edema. Preoperative and postoperative spectral-domain optical coherence tomography (OCT) was examined for macular thickness and macular volume. Outcomes and variables were analyzed using the two-tailed t-test and Spearman's rank correlation coefficient.
Twenty-four eyes from 11 men and 10 women of mean age 69 (range 55-84) years were included. Four patients (17%) had chronic macular edema from uveitis, four (17%) from retinal vein occlusion, and 16 (67%) from diabetes. Mean visual acuity was 20/103 preoperatively and 20/87 postoperatively (P = 0.55). Sixty-three percent of the eyes had improved vision (47% better than 20/40), 21% maintained the same vision, and 17% had worse vision. Forty-seven percent of improved eyes and 30% of total eyes gained more than two lines of visual acuity (range -9 to +7 lines). Mean macular thickness was 455 μm preoperatively and 396 μm postoperatively (P = 0.29). Mean macular volume was 7.9 mm(3) preoperatively and 7.5 mm(3) postoperatively (P = 0.51). The strongest predictor of postoperative visual acuity was initial visual acuity (r = 0.673, P = 0.0003).
Even though a majority of patients had improved vision and decreased macular thickening after 25-gauge pars plana vitrectomy with internal limiting membrane peeling for chronic macular edema of various etiologies, the difference in visual acuity or macular thickening did not reach statistical significance.
本研究的目的是调查接受25G玻璃体切除术联合内界膜剥除术的慢性黄斑水肿患者的视力和解剖学结果。
本研究是一项回顾性图表分析，纳入了21例接受25G玻璃体切除术联合吲哚菁绿辅助内界膜剥除术治疗慢性黄斑水肿的患者的24只眼。术前和术后使用光谱域光学相干断层扫描（OCT）检查黄斑厚度和黄斑体积。采用双尾t检验和Spearman等级相关系数分析结果和变量。
纳入了11名男性和10名女性的24只眼，平均年龄69岁（范围55 - 84岁）。4例（17%）患者的慢性黄斑水肿由葡萄膜炎引起，4例（17%）由视网膜静脉阻塞引起，16例（67%）由糖尿病引起。术前平均视力为20/103，术后为20/87（P = 0.55）。63%的患眼视力改善（47%优于20/40），21%视力维持不变，17%视力下降。47%视力改善的患眼和30%的所有患眼视力提高超过两行（范围-9至+7行）。术前平均黄斑厚度为455μm，术后为396μm（P = 0.29）。术前平均黄斑体积为7.9mm³，术后为7.5mm³（P = 0.51）。术后视力的最强预测因素是初始视力（r = 0.673，P = 0.0003）。
尽管大多数患者在接受25G玻璃体切除术联合内界膜剥除术治疗各种病因的慢性黄斑水肿后视力有所改善且黄斑增厚减轻，但视力或黄斑增厚的差异未达到统计学意义。
