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巨大出血性息肉样脉络膜血管病变中的玻璃体积血:临床特征及手术结果:息肉样脉络膜血管病变中的玻璃体积血

Vitreous haemorrhage in massive hemorrhagic polypoidal choroidal vasculopathy: clinical characteristics and surgical outcomes: Vitreous hemorrhage in PCV.

作者信息

Narayanan Raja, Mithal Kopal, Jalali Subhadra, Chhablani Jay Kumar, Mathai Annie, Ali Md Hasnat

机构信息

Srimati Kanuri Santhamma Retina Vitreous Centre, L V Prasad Eye Institute, L V Prasad Marg, Banjara Hills, Hyderabad, Andhra Pradesh 500 034 India.

Department of Biostatistics, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, India.

出版信息

Int J Retina Vitreous. 2015 Dec 20;1:25. doi: 10.1186/s40942-015-0025-4. eCollection 2015.

Abstract

BACKGROUND

To report the outcomes of vitreous hemorrhage (VH) associated with hemorrhagic polypoidal choroidal vasculopathy (PCV).

METHODS

A retrospective study of 28 eyes of 27 consecutive patients of hemorrhagic PCV with VH, which were managed surgically between January 2003 and December 2011, was performed. All patients underwent pars plana vitrectomy for VH associated with PCV. The main outcome measure was best-corrected visual acuity (BCVA) at baseline, at 1, 3 and 6 months post operatively and at last follow up.

RESULTS

The visual acuity measured on early treatment diabetic retinopathy study (ETDRS) chart improved in 16 eyes (57.1 %) by two or more lines, remained unchanged in nine eyes (32.1 %) and decreased in three (10.7 %) after surgery when compared to baseline VA. The mean baseline VA was 2.69 ± 0.57 logMAR units (<20/2000) which improved to 1.65 ± 0.93 logMAR units (20/800) at 1 month post operative visit and was sustained at 1.72 ± 1.12 (20/800) with an improvement of 0.96 logMAR units (p < 0.001, 95 % CI 0.54-1.37). The average postoperative follow up was for 14.2 months (range 1-84). The complications noted in postoperative follow up were cataract (n = 10), macular scaring (n = 9), organised dehemoglobinised blood (n = 7), retinal tear or detachment (n = 5), recurrent VH (n = 3) and choroidal detachment (n = 1).

CONCLUSION

Majority of patients with loss of vision due to VH secondary to hemorrhagic PCV have sustained improvement in visual acuity following surgery.

摘要

背景

报告与出血性息肉样脉络膜血管病变(PCV)相关的玻璃体积血(VH)的治疗结果。

方法

对2003年1月至2011年12月间连续27例患有出血性PCV并伴有VH的患者的28只眼睛进行回顾性研究,所有患者均接受了针对与PCV相关的VH的玻璃体切除术。主要观察指标为基线时、术后1个月、3个月和6个月以及最后一次随访时的最佳矫正视力(BCVA)。

结果

与基线视力相比,术后16只眼(57.1%)在早期糖尿病视网膜病变研究(ETDRS)视力表上的视力提高了两行或更多行,9只眼(32.1%)保持不变,3只眼(10.7%)下降。平均基线视力为2.69±0.57 logMAR单位(<20/2000),术后1个月时提高到1.65±0.93 logMAR单位(20/800),并在最后随访时维持在1.72±1.12(20/800),提高了0.96 logMAR单位(p<0.001,95%CI 0.54 - 1.37)。术后平均随访时间为14.2个月(范围1 - 八十四)。术后随访中发现的并发症有白内障(n = 10)、黄斑瘢痕(n = 9)、机化血红蛋白化血(n = 7)、视网膜裂孔或脱离(n = 5)、复发性VH(n = 3)和脉络膜脱离(n = 1)。

结论

大多数因出血性PCV继发VH而视力丧失的患者术后视力持续改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c80/5088469/2de19c76e01b/40942_2015_25_Fig1_HTML.jpg

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