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近期发生的黄斑脱离孔源性视网膜脱离的形态学改变与功能转归的相关性:孔源性视网膜脱离的预后因素

Correlation between morphological changes and functional outcomes of recent-onset macula-off rhegmatogenous retinal detachment: prognostic factors in rhegmatogenous retinal detachment.

作者信息

Karacorlu Murat, Sayman Muslubas Isil, Hocaoglu Mumin, Arf Serra, Ersoz Mehmet Giray

机构信息

Istanbul Retina Institute, Hakkı Yeten Cad. Unimed Center No: 19/7, Fulya - Şişli, 34349, Istanbul, Turkey.

出版信息

Int Ophthalmol. 2018 Jun;38(3):1275-1283. doi: 10.1007/s10792-017-0591-6. Epub 2017 Jun 10.

Abstract

PURPOSE

To assess correlation between preoperative and postoperative findings and surgical factors, and postoperative functional outcomes after successful repair of acute macula-off rhegmatogenous retinal detachment (RRD).

METHODS

Forty-four eyes of 44 patients with recent-onset macula-off RRD who had primary pars plana vitrectomy were included in this retrospective study. Best-corrected visual acuity (BCVA) and retinal and choroidal changes on spectral-domain optical coherence tomography (SD-OCT) were evaluated before and after surgery. Correlation between preoperative and postoperative variables such as demographic and clinical data, SD-OCT findings and surgical factors, and postoperative functional outcomes were assessed.

RESULTS

Eighteen women and 26 men, whose mean age at the onset of RRD was 51.7 ± 14.4 years, were evaluated. The mean preoperative and postoperative logMAR BCVA were 1.1 ± 0.5 (20/250) and 0.14 ± 0.1 (20/30), respectively, after a mean of 16.7 ± 7.2 months. Although all factors were evaluated as prognostic factors for functional outcome after surgical treatment of recent-onset macula-off RRD, epiretinal membrane formation was found as the only factor affecting postoperative visual acuity.

CONCLUSION

Satisfactory visual recovery can be achieved after a successful surgery in patients with acute RRD without any association with morphological changes such as increased subretinal fluid, central foveal thickness, subfoveal choroidal thickness, cystic spaces in the inner nuclear layer and/or outer nuclear layer, undulation of separated outer retina, and disruption of the photoreceptor layer. Epiretinal membrane formation may affect visual outcome in these patients.

摘要

目的

评估急性黄斑脱离性孔源性视网膜脱离(RRD)成功修复术后术前与术后检查结果及手术因素之间的相关性,以及术后功能转归。

方法

本回顾性研究纳入了44例近期发生黄斑脱离性RRD且接受了一期玻璃体切除术的患者的44只眼。在手术前后评估最佳矫正视力(BCVA)以及光谱域光学相干断层扫描(SD-OCT)检查发现的视网膜和脉络膜变化。评估术前与术后变量之间的相关性,这些变量包括人口统计学和临床数据、SD-OCT检查结果、手术因素以及术后功能转归。

结果

对18名女性和26名男性进行了评估,他们RRD发病时的平均年龄为51.7±14.4岁。平均16.7±7.2个月后,术前和术后平均logMAR BCVA分别为1.1±0.5(20/250)和0.14±0.1(20/30)。尽管所有因素均被评估为近期发生黄斑脱离性RRD手术治疗后功能转归的预后因素,但发现视网膜前膜形成是影响术后视力的唯一因素。

结论

急性RRD患者手术成功后可实现满意的视力恢复,且与视网膜下液增加、中心凹厚度、黄斑下脉络膜厚度、内核层和/或外核层的囊腔、分离的外层视网膜起伏以及光感受器层破坏等形态学变化无关。视网膜前膜形成可能会影响这些患者的视力转归。

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