Shirakata Yukari, Fujita Tomoyoshi, Nakano Yuki, Shiraga Fumio, Tsujikawa Akitaka
Department of Ophthalmology, Kagawa University Faculty of Medicine, Takamatsu, Okayama, Japan.
Department of Ophthalmology, Okayama University, Okayama, Japan.
Case Rep Ophthalmol. 2016 Jan 8;7(1):1-8. doi: 10.1159/000443322. eCollection 2016 Jan-Apr.
To evaluate the efficacy of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) peeling in cases of ischemic central retinal vein occlusion (CRVO) where macular edema (ME) persisted after anti-vascular endothelial growth factor (anti-VEGF) treatment.
Fifteen eyes with ischemic CRVO-related ME were included in the study. Nine were treated with panretinal photocoagulation after initial examination. Anti-VEGF agents were injected intravitreally. Persistent ME was treated with PPV combined with ILM peeling. During surgery, laser photocoagulation was further applied to the non-perfused area.
Mean retinal thickness gradually decreased after surgery (p = 0.024 at 6 months), although visual acuity did not improve significantly during the follow-up period (14.7 ± 11.6 months). Neovascular glaucoma subsequently developed in three cases and a trabeculectomy was performed in one case.
In eyes with ischemic CRVO, PPV combined with ILM peeling contributed to a reduction in persistent ME. However, there was no significant improvement in visual acuity.
评估在抗血管内皮生长因子（抗VEGF）治疗后黄斑水肿（ME）仍持续存在的缺血性中央视网膜静脉阻塞（CRVO）病例中，玻璃体切割术（PPV）联合内界膜（ILM）剥除术的疗效。
本研究纳入15只患有缺血性CRVO相关ME的眼睛。9只眼睛在初次检查后接受了全视网膜光凝治疗。玻璃体内注射抗VEGF药物。持续性ME采用PPV联合ILM剥除术治疗。手术过程中，对无灌注区进一步进行激光光凝。
术后平均视网膜厚度逐渐降低（6个月时p = 0.024），尽管在随访期间视力没有显著改善（14.7 ± 11.6个月）。随后3例发生新生血管性青光眼，1例行小梁切除术。
在患有缺血性CRVO的眼睛中，PPV联合ILM剥除术有助于减轻持续性ME。然而，视力没有显著改善。
