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成人非创伤性非糖尿病性视网膜病变所致致密玻璃体出血的早期玻璃体切除术

Early vitrectomy for dense vitreous hemorrhage in adults with non-traumatic and non-diabetic retinopathy.

作者信息

Zhang Ting, Zhang Jingjing, Sun Xiaolei, Tian Jingyi, Shi Weiyun, Yuan Gongqiang

机构信息

Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan, China.

出版信息

J Int Med Res. 2017 Dec;45(6):2065-2071. doi: 10.1177/0300060517708942. Epub 2017 Jun 19.

Abstract

Objective To evaluate the etiologies for dense vitreous hemorrhage in adults with non-traumatic and reveal management of early vitrectomy for the disease. Methods Study included 105 eyes from 105 patients. Outcome measures were etiologies of vitreous hemorrhage, formation of retinal and/or disk neovascular membrane (NVM), incidence of retinal tear and detachment, visual acuity (VA) and postoperative complications. Results Mean time between presentation and surgery was 7.1 days. The most common etiologies were retinal vein occlusion (RVO) (58.1%), retinal tear (22.9%) and retinal vasculitis (10.4%). Most RVO (77.0%) and retinal vasculitis (72.7%) eyes were associated with retinal and/or disk NVM. Retinal tear and retinal detachment was found in 24 and 48 eyes, respectively. VA improved significantly from 1/70 to 0.6 following vitrectomy. The most common postoperative complication was cataract (28.6%). Conclusion RVO, retinal tear and retinal vasculitis were the most common causes of dense vitreous hemorrhage. Early vitrectomy has a good outcome with acceptable complication rates in this setting.

摘要

目的 评估非创伤性成人致密玻璃体出血的病因,并揭示该疾病早期玻璃体切除术的治疗方法。方法 研究纳入了105例患者的105只眼。观察指标包括玻璃体出血的病因、视网膜和/或视盘新生血管膜(NVM)的形成、视网膜裂孔和脱离的发生率、视力(VA)及术后并发症。结果 就诊至手术的平均时间为7.1天。最常见的病因是视网膜静脉阻塞(RVO)(58.1%)、视网膜裂孔(22.9%)和视网膜血管炎(10.4%)。大多数RVO(77.0%)和视网膜血管炎(72.7%)的患眼伴有视网膜和/或视盘NVM。分别在24只和48只眼中发现视网膜裂孔和视网膜脱离。玻璃体切除术后视力从1/70显著提高到0.6。最常见的术后并发症是白内障(28.6%)。结论 RVO、视网膜裂孔和视网膜血管炎是致密玻璃体出血最常见的原因。在这种情况下,早期玻璃体切除术效果良好,并发症发生率可接受。

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