Kusuhara Sentaro, Matsumiya Wataru, Imai Hisaori, Honda Shigeru, Tsukahara Yasutomo, Negi Akira
Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Ophthalmologica. 2014;232(3):170-8. doi: 10.1159/000364811. Epub 2014 Oct 15.
To investigate the incidence of and risk factors for a dissociated optic nerve fiber layer (DONFL) appearance after pars plana vitrectomy (PPV).
We retrospectively reviewed 189 eyes that underwent PPV with internal limiting membrane removal and judged the presence/absence of an apparent DONFL based on en face layer images produced by spectral-domain optical coherence tomography (SD-OCT).
An apparent DONFL was observed in 47 (24.9%) eyes. The incidence of an apparent DONFL was significantly higher in the macular hole (MH) group (76.5%) than in the non-MH group (epiretinal membrane, diabetic macular edema, retinal vein occlusion, and others; 4.9%; p < 0.001). In the logistic regression analysis, surgical indication for MH was identified as the most significant DONFL risk factor (odds ratio 63.7; p = 1.05 × 10(-8)).
Postoperative OCT en face layer imaging clarified that MH eyes are liable to have an apparent DONFL following PPV.
研究玻璃体切割术（PPV）后视神经纤维层分离（DONFL）外观的发生率及危险因素。
我们回顾性分析了189例行PPV联合内界膜剥除术的患眼，并根据光谱域光学相干断层扫描（SD-OCT）生成的表面层图像判断是否存在明显的DONFL。
47只（24.9%）患眼观察到明显的DONFL。黄斑裂孔（MH）组明显DONFL的发生率（76.5%）显著高于非MH组（视网膜前膜、糖尿病性黄斑水肿、视网膜静脉阻塞等；4.9%；p<0.001）。在逻辑回归分析中，MH的手术指征被确定为最显著的DONFL危险因素（比值比63.7；p=1.05×10⁻⁸）。
术后OCT表面层成像显示，MH患眼在PPV后容易出现明显的DONFL。
