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采用黄斑旁激光光凝的玻璃体切除术与不采用黄斑旁激光光凝的玻璃体切除术治疗视盘小凹黄斑病变:KKESH国际视网膜协作研究组的结果

Pars plana vitrectomy with juxtapapillary laser photocoagulation versus vitrectomy without juxtapapillary laser photocoagulation for the treatment of optic disc pit maculopathy: the results of the KKESH International Collaborative Retina Study Group.

作者信息

Abouammoh Marwan A, Alsulaiman Sulaiman M, Gupta Vishali S, Mousa Ahmed, Hirakata Akito, Berrocal Maria H, Chenworth Megan, Chhablani Jay, Oshima Yusuke, AlZamil Waseem M, Casella Antonio Marcelo, Papa-Oliva Gabriela, Banker Alay S, Arevalo J Fernando

机构信息

Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

出版信息

Br J Ophthalmol. 2016 Apr;100(4):478-83. doi: 10.1136/bjophthalmol-2015-307128. Epub 2015 Aug 20.

Abstract

BACKGROUND/AIMS: To compare the functional and anatomic outcomes of pars plana vitrectomy (PPV) with juxtapapillary laser photocoagulation (JLP) versus vitrectomy without JLP in optic disc pit maculopathy.

METHODS

This was a multicentre, retrospective study of 46 consecutive patients with optic disc pit maculopathy presenting at tertiary eye centres between 1992 and 2012. Indications for surgery included distorted or decreased vision. Surgical intervention included PPV, posterior vitreous detachment, with or without gas tamponade. Twenty-four patients received laser photocoagulation at the temporal edge of the optic disc pit (group A) and 22 patients had no laser (group B). Postoperative best-corrected visual acuity (BCVA) and optical coherence tomography findings were the main outcome measures.

RESULTS

Mean follow-up was 44 months (range 12-98 months). BCVA in group A improved significantly from 0.7 logMAR (20/100) preoperatively to 0.5 logMAR (20/60) postoperatively (p=0.017). In group B, BCVA improved from 0.7 logMAR (20/100) preoperatively to 0.4 logMAR (20/40) postoperatively (p=0.014). The difference in final BCVA between groups was not statistically significant (p=0.693). The mean central macular thickness (CMT) in group A improved significantly from 750 μm preoperatively to 309 μm at last follow-up (p<0.0001). The mean CMT in group B improved from 616 μm preoperatively to 291 μm at last follow-up (p=0.028). The difference in final CMT between groups was not statistically significant (p=0.747).

CONCLUSIONS

PPV with JLP for optic disc pit maculopathy had similar functional and anatomic outcomes compared with vitrectomy without JLP.

摘要

背景/目的:比较玻璃体切除术联合视盘旁激光光凝术(JLP)与单纯玻璃体切除术治疗视盘小凹黄斑病变的功能和解剖学结局。

方法

这是一项多中心回顾性研究,纳入了1992年至2012年间在三级眼科中心就诊的46例连续性视盘小凹黄斑病变患者。手术指征包括视力扭曲或下降。手术干预包括玻璃体切除术、玻璃体后脱离,可联合或不联合气体填充。24例患者在视盘小凹颞侧边缘接受了激光光凝术(A组),22例患者未接受激光治疗(B组)。术后最佳矫正视力(BCVA)和光学相干断层扫描结果是主要观察指标。

结果

平均随访44个月(范围12 - 98个月)。A组BCVA从术前的0.7 logMAR(20/100)显著提高至术后的0.5 logMAR(20/60)(p = 0.017)。B组BCVA从术前的0.7 logMAR(20/100)提高至术后的0.4 logMAR(20/40)(p = 0.014)。两组最终BCVA的差异无统计学意义(p = 0.693)。A组平均中心黄斑厚度(CMT)从术前的750μm显著改善至最后一次随访时的309μm(p < 0.0001)。B组平均CMT从术前的616μm改善至最后一次随访时的291μm(p = 0.028)。两组最终CMT的差异无统计学意义(p = 0.747)。

结论

视盘小凹黄斑病变采用玻璃体切除术联合JLP与单纯玻璃体切除术相比,具有相似的功能和解剖学结局。

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