Greven Margaret A, Garg Sunir, Chiu Bing, Shah Sumit P, Wolfe Jeremy, Fine Howard F, Roth Daniel B, Robinson Joshua, Mong Jacob, Hsu Jason, Regillo Carl, Ho Allen, Haller Julia A
Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania, USA Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California, USA.
Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania, USA.
Br J Ophthalmol. 2016 Sep;100(9):1211-5. doi: 10.1136/bjophthalmol-2015-307701. Epub 2015 Dec 9.
BACKGROUND/AIMS: To describe the results of pars plana vitrectomy (PPV) for persistent symptomatic vitreomacular traction (VMT) with or without macular hole (MH) after intravitreal ocriplasmin injection.
Multicentre retrospective study of eyes that received intravitreal ocriplasmin between January 2013 and January 2014 for symptomatic VMT with or without MH, and then went on to PPV (ocriplasmin-treated group) for persistent pathology, compared with a control group of patients with symptomatic VMT with or without MH who were offered ocriplasmin injection but proceeded directly to PPV (PPV-only group). Intraoperative characteristics, visual acuity (VA) outcomes and spectral-domain optical coherence tomography images were reviewed for the two groups. Primary outcome measure was VA after PPV.
51 eyes of 51 patients underwent PPV after receiving ocriplasmin, and 22 eyes of 22 patients proceeded directly to PPV. Although VA was significantly better at all time points in the PPV-only compared with the ocriplasmin-treated group, at 3 and 6 months after PPV both groups had similar amount of visual improvement. Both groups had similar rates of pathology resolution; 50/51 (98%) eyes in the ocriplasmin group and 22/22 (100%) eyes in the PPV-only group had release of VMT and/or MH closure after PPV. The two groups had similar PPV-related complication rates.
Eyes with persistent symptomatic VMT and/or MH have similarly high rates of pathology resolution as well as similar VA gains regardless of whether they received ocriplasmin prior to PPV.
背景/目的:描述玻璃体内注射奥克纤溶酶后,针对伴有或不伴有黄斑裂孔(MH)的持续性症状性玻璃体黄斑牵引(VMT)进行玻璃体切割术(PPV)的结果。
对2013年1月至2014年1月期间因伴有或不伴有MH的症状性VMT而接受玻璃体内奥克纤溶酶注射,随后因持续性病变而进行PPV的眼睛进行多中心回顾性研究(奥克纤溶酶治疗组),并与一组伴有或不伴有MH的症状性VMT患者作为对照组进行比较,这些患者接受了奥克纤溶酶注射,但直接进行了PPV(单纯PPV组)。对两组患者的术中特征、视力(VA)结果和频域光学相干断层扫描图像进行了回顾。主要结局指标是PPV后的VA。
51例患者的51只眼睛在接受奥克纤溶酶后进行了PPV,22例患者的22只眼睛直接进行了PPV。虽然单纯PPV组在所有时间点的VA均显著优于奥克纤溶酶治疗组,但在PPV后3个月和6个月,两组的视力改善程度相似。两组的病变缓解率相似;奥克纤溶酶组51只眼中的50只(98%)和单纯PPV组22只眼中的22只(100%)在PPV后VMT解除和/或MH闭合。两组的PPV相关并发症发生率相似。
伴有持续性症状性VMT和/或MH的眼睛,无论在PPV前是否接受奥克纤溶酶治疗,其病变缓解率和视力提高程度均相似。