Goto So, Sayanagi Kaori, Ikuno Yasushi, Jo Yukari, Gomi Fumi, Nishida Kohji
Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
Retina. 2015 Mar;35(3):429-34. doi: 10.1097/IAE.0000000000000332.
To compare the long-term outcomes of simple hemorrhage (SH) without any treatments and myopic choroidal neovascularization (mCNV) treated with intravitreal bevacizumab in highly myopic eyes.
Twenty eyes (17 patients) with SH and 28 eyes (27 patients) with mCNV were included. We retrospectively evaluated the refractive error, axial length, age, best-corrected visual acuity, and the integrity of photoreceptor inner segment/outer segment junction and compared the two groups.
The mean patient age was 41.6 ± 11.2 years, the mean refractive error -12.7 ± 3.57 diopters, and the mean axial length was 29.64 ± 1.42 mm. Patients in the SH group were significantly (P < 0.001) younger than those in the mCNV group (34.8 vs. 46.5 years, respectively). There were no significant differences in other parameters between the groups. Compared with baseline, the best-corrected visual acuity improved significantly (P < 0.01) at 12 months in both groups. The change in vision at 12 months in the SH group was significantly (P < 0.05) better than that in the mCNV group, although there were no significant differences at 3 months or 6 months. The final integrity of photoreceptor inner segment/outer segment junction was significantly associated with the final best-corrected visual acuity (P < 0.05).
Eyes with SH had a more favorable visual prognosis compared with eyes with mCNV treated with intravitreal bevacizumab. The differential diagnosis of these pathologies is important.
比较高度近视眼中未经任何治疗的单纯性出血(SH)和接受玻璃体内注射贝伐单抗治疗的近视性脉络膜新生血管(mCNV)的长期预后。
纳入20只患有SH的眼(17例患者)和28只患有mCNV的眼(27例患者)。我们回顾性评估了屈光不正、眼轴长度、年龄、最佳矫正视力以及光感受器内节/外节连接的完整性,并对两组进行了比较。
患者平均年龄为41.6±11.2岁,平均屈光不正为-12.7±3.57屈光度,平均眼轴长度为29.64±1.42mm。SH组患者明显(P<0.001)比mCNV组患者年轻(分别为34.8岁和46.5岁)。两组之间的其他参数无显著差异。与基线相比,两组在12个月时最佳矫正视力均有显著改善(P<0.01)。SH组在12个月时的视力变化明显(P<0.05)优于mCNV组,尽管在3个月或6个月时无显著差异。光感受器内节/外节连接的最终完整性与最终最佳矫正视力显著相关(P<0.05)。
与接受玻璃体内注射贝伐单抗治疗的mCNV眼相比,SH眼具有更有利的视力预后。对这些病变进行鉴别诊断很重要。