Uchida Atsuro, Shinoda Hajime, Koto Takashi, Mochimaru Hiroshi, Nagai Norihiro, Tsubota Kazuo, Ozawa Yoko
Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Retina. 2014 Mar;34(3):455-60. doi: 10.1097/IAE.0b013e3182a0e477.
To evaluate the outcome of vitrectomy with internal limiting membrane peeling and no gas tamponade in the treatment of eyes with myopic foveoschisis.
Medical records of 10 eyes of 9 consecutive patients with myopic foveoschisis without macular hole treated by vitrectomy were reviewed.
The patients' refractive error was -4.00 diopters to -34.00 diopters, and axial length was 28.38 mm to 35.90 mm. Six eyes had foveal retinal detachment with retinoschisis. All cases were treated by vitrectomy with internal limiting membrane removal without gas tamponade. The mean preoperative best-corrected visual acuity was 0.61 ± 0.42 in logarithm of the minimum angle of resolution units (Snellen equivalent of 20/82). Myopic foveoschisis was reduced in 8 eyes (80%) with a single surgery. Two eyes without improvement developed a postoperative macular hole and were treated by additional vitreoretinal surgery. All 10 eyes showed anatomical repair, and 5 eyes showed improvement in best-corrected visual acuity to 0.47 ± 0.48 (Snellen equivalent of 20/60), by 17 months after the initial surgery.
Vitrectomy with internal limiting membrane peeling and no gas tamponade can effectively treat some cases of myopic foveoschisis, suggesting that tractional forces at the vitreoretinal interface may contribute to the pathogenesis of myopic foveoschisis, thereby avoiding gas tamponade.
评估玻璃体切割联合内界膜剥除且不使用气体填充治疗近视性黄斑劈裂的效果。
回顾性分析9例连续患者10只眼近视性黄斑劈裂且无黄斑裂孔行玻璃体切割术的病历资料。
患者屈光不正度数为-4.00至-34.00屈光度,眼轴长度为28.38至35.90mm。6只眼存在黄斑视网膜脱离合并视网膜劈裂。所有病例均行玻璃体切割联合内界膜剥除且不使用气体填充治疗。术前平均最佳矫正视力为0.61±0.42最小分辨角对数视力表单位(相当于Snellen视力表的20/82)。单次手术使8只眼(80%)的近视性黄斑劈裂减轻。2只眼无改善且术后出现黄斑裂孔,随后接受了额外的玻璃体视网膜手术。所有10只眼均实现解剖修复,至初次手术后17个月,5只眼最佳矫正视力提高至0.47±0.48(相当于Snellen视力表的20/60)。
玻璃体切割联合内界膜剥除且不使用气体填充可有效治疗部分近视性黄斑劈裂病例,提示玻璃体视网膜界面的牵拉力可能在近视性黄斑劈裂的发病机制中起作用,从而避免使用气体填充。