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预测增殖性糖尿病视网膜病变第二只眼玻璃体切割术的视觉预后。

PREDICTING VISUAL OUTCOMES OF SECOND EYE VITRECTOMY FOR PROLIFERATIVE DIABETIC RETINOPATHY.

机构信息

Oxford Eye Hospital, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.

Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.

出版信息

Retina. 2018 Apr;38(4):698-707. doi: 10.1097/IAE.0000000000001589.

DOI:10.1097/IAE.0000000000001589
PMID:28333877
Abstract

PURPOSE

To investigate predictive factors for visual outcome in the second operated eye of patients undergoing bilateral vitrectomy for proliferative diabetic retinopathy.

METHODS

Clinical records of 55 patients undergoing bilateral vitrectomy for proliferative diabetic retinopathy at the University Eye Hospital Ljubljana between January 2009 and December 2014 were examined retrospectively. Statistical analysis was performed to identify variables associated with good visual outcomes.

RESULTS

Mean preoperative visual acuity was 6/181 Snellen (1.48 ± 0.47 logarithm of minimal angle of resolution [logMAR]). The follow-up period after vitrectomy was at least 1 year and mean postoperative visual acuity improved to 6/31 Snellen (0.71 ± 0.62 logMAR). On univariate analysis, variables predicting good postoperative vision (6/12 Snellen or better) were the following: absence of macular detachment (P = 0.009), previously performed full panretinal laser (P = 0.03), and good vision in the previously vitrectomized fellow eye (P < 0.001). On multivariate analysis, the absence of macular detachment (P = 0.001) and good vision in the previously vitrectomized fellow eye (P < 0.001) were both independently associated with good visual outcome.

CONCLUSION

In patients undergoing second eye vitrectomy for complications of proliferative diabetic retinopathy, the visual acuity of previously operated fellow eye and the presence of macular detachment in the eye due for vitrectomy may be strong independent predicting factors for visual outcome.

摘要

目的

研究接受双侧玻璃体切除术治疗增殖性糖尿病视网膜病变的患者中,第二只手术眼的视力预后的预测因素。

方法

回顾性分析 2009 年 1 月至 2014 年 12 月在卢布尔雅那大学眼科医院接受双侧玻璃体切除术治疗增殖性糖尿病视网膜病变的 55 例患者的临床记录。进行统计分析以确定与良好视力结局相关的变量。

结果

平均术前视力为 6/181 (Snellen)(1.48 ± 0.47 最小视角分辨率对数[logMAR])。玻璃体切除术后的随访期至少为 1 年,平均术后视力提高至 6/31 (Snellen)(0.71 ± 0.62 logMAR)。单变量分析表明,预测术后良好视力(6/12 或更好)的变量包括:无黄斑脱离(P = 0.009)、先前进行过全视网膜光凝(P = 0.03)和先前玻璃体切除的对侧眼视力良好(P < 0.001)。多变量分析表明,无黄斑脱离(P = 0.001)和先前玻璃体切除的对侧眼视力良好(P < 0.001)均与良好的视力结局独立相关。

结论

在因增殖性糖尿病视网膜病变并发症而接受第二只眼玻璃体切除术的患者中,先前手术的对侧眼的视力和即将进行玻璃体切除术的眼中黄斑脱离的存在可能是视力结局的强烈独立预测因素。

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