Joe Soo Geun, Kim Yoon Jeon, Chae Ju Byung, Yang Sung Jae, Lee Joo Yong, Kim June-Gone, Yoon Young Hee
Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2013 Jun;27(3):178-85. doi: 10.3341/kjo.2013.27.3.178. Epub 2013 May 7.
To investigate correlations between preoperative and postoperative foveal microstructures in patients with macula-off rhegmatogenous retinal detachment (RRD).
We reviewed the records of 31 eyes from 31 patients with macula-off RRD who had undergone successful re-attachment surgery. We analyzed data obtained from complete ophthalmologic examinations and optical coherence tomography (OCT) before and 9 to 12 months after surgery. All postoperative OCT measurements were taken with spectral-domain OCT, but a subset of preoperative OCT measurements were taken with time-domain OCT.
The mean duration of macular detachment was 15.5 ± 15.2 days, and mean preoperative best-corrected visual acuity (BCVA, logarithm of the minimum angle of resolution) was 1.03 ± 0.68. Preoperative visual acuity was correlated with retinal detachment height (p < 0.001) and the existence of intraretinal separation (IRS) along with outer layer undulation (OLU) (p = 0.022), but not with macula-off duration. The final BCVA was significantly correlated with integrity of the junction between the photoreceptor inner and outer segments (IS/OS) combined with the continuity of external limiting membrane (ELM) (p = 0.025). The presence of IRS and OLU on a detached macula were highly correlated with the final postoperative integrity of the IS/OS junction and the ELM (p = 0.017).
Eyes preoperatively exhibiting IRS and OLU showed a higher incidence of disruption to the photoreceptor IS/OS junction and the ELM at final follow-up. Such a close correlation between preoperative and postoperative structural changes may explain why ultimate visual recovery in such eyes is poor.
研究黄斑脱离性孔源性视网膜脱离(RRD)患者术前和术后黄斑部微结构之间的相关性。
我们回顾了31例黄斑脱离性RRD患者的31只眼的记录,这些患者均接受了成功的复位手术。我们分析了术前以及术后9至12个月完整眼科检查和光学相干断层扫描(OCT)所获得的数据。所有术后OCT测量均使用光谱域OCT进行,但术前OCT测量的一部分是使用时域OCT进行的。
黄斑脱离的平均持续时间为15.5±15.2天,术前平均最佳矫正视力(BCVA,最小分辨角的对数)为1.03±0.68。术前视力与视网膜脱离高度(p<0.001)以及视网膜内分离(IRS)和外层波动(OLU)的存在相关(p = 0.022),但与黄斑脱离持续时间无关。最终BCVA与光感受器内节和外节(IS/OS)之间连接的完整性以及外限制膜(ELM)的连续性显著相关(p = 0.025)。脱离黄斑上IRS和OLU的存在与术后最终IS/OS连接和ELM的完整性高度相关(p = 0.017)。
术前表现出IRS和OLU的眼在最终随访时光感受器IS/OS连接和ELM破坏的发生率更高。术前和术后结构变化之间的这种密切相关性可能解释了为什么这类眼最终的视力恢复较差。