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获得性类玻璃体细胞病变与视网膜色素上皮脱离相关的临床特征。

Clinical findings of acquired vitelliform lesions associated with retinal pigment epithelial detachments.

机构信息

Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan; LuEster T. Mertz Retinal Research Center, Manhattan Eye Ear and Throat Hospital and Vitreous-Retina-Macula Consultants of New York, New York, New York.

Department of Ophthalmology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.

出版信息

Am J Ophthalmol. 2014 Feb;157(2):355-365.e2. doi: 10.1016/j.ajo.2013.10.009. Epub 2013 Oct 19.

Abstract

PURPOSE

To study clinical findings associated with acquired vitelliform lesions in retinal pigment epithelial detachments (PEDs).

DESIGN

Retrospective, interventional, consecutive case series.

METHODS

We retrospectively reviewed 32 eyes of 24 patients (22 men, 2 women; age range [mean], 58-85 [73.7] years) with acquired vitelliform lesions.

RESULTS

All eyes had acquired vitelliform lesions in the central macula associated with a serous PED at baseline. Of the 32 eyes, 30 (93.8%) were observed for 12 months, 26 (81.3%) for 24 months, and 17 (53.1%) for 36 months. The mean logarithm of the minimal angle of resolution best-corrected visual acuity (BCVA) levels were 0.19 at month 12, 0.28 at month 24, and 0.25 at month 36, none of which differed significantly from baseline. The mean changes in the BCVA were declines of 0.38, 1.29, and 1.21 lines at months 12, 24, and 36, respectively. Of 7 eyes treated with 3 consecutive monthly intravitreal injections of ranibizumab, the serous PEDs remained in all 7 eyes and the mean changes of BCVA were a decline of 2.40 lines 12 months after the first injection and a decline of 3.58 lines at the final visit. In the 24 untreated eyes, the mean change in the BCVA was a decline of 0.25 line at the final visit, which differed significantly (P = .021) compared with that of the treated eyes at the final visit.

CONCLUSION

Intravitreal injections of ranibizumab were ineffective because of the absence of resolution of the PEDs and the declines in VA.

摘要

目的

研究与视网膜色素上皮脱离(PED)中的获得性玻璃膜疣相关的临床发现。

设计

回顾性、干预性、连续病例系列。

方法

我们回顾性地研究了 24 名患者(22 名男性,2 名女性;年龄范围[平均值],58-85 [73.7]岁)的 32 只眼的获得性玻璃膜疣。

结果

所有眼睛的中央黄斑均存在获得性玻璃膜疣,并伴有基线时的浆液性 PED。在 32 只眼中,30 只(93.8%)观察了 12 个月,26 只(81.3%)观察了 24 个月,17 只(53.1%)观察了 36 个月。最佳矫正视力(BCVA)最小角度分辨率对数均值在第 12 个月时为 0.19,第 24 个月时为 0.28,第 36 个月时为 0.25,与基线均无显著差异。BCVA 的平均变化分别为第 12、24 和 36 个月时下降 0.38、1.29 和 1.21 行。在 7 只接受 3 次连续每月玻璃体内注射雷珠单抗治疗的眼中,7 只眼的浆液性 PED 均持续存在,在第一次注射后 12 个月,BCVA 的平均变化为下降 2.40 行,在最后一次就诊时下降 3.58 行。在 24 只未治疗的眼中,BCVA 的平均变化为最后一次就诊时下降 0.25 行,与治疗眼最后一次就诊时的变化有显著差异(P =.021)。

结论

由于 PED 未解决和 VA 下降,玻璃体内注射雷珠单抗无效。

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