Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Ophthalmology, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Retina. 2018 Aug;38(8):1533-1540. doi: 10.1097/IAE.0000000000001760.
To assess the long-term functional and anatomical outcomes for vitreomacular traction syndrome (VMT) after vitrectomy and to analyze the predictive factors regarding visual outcome.
A retrospective, consecutive case series of 22 eyes in 22 patients with VMT who underwent vitrectomy to relieve macular edema were studied. Eyes were classified into two groups according to the diameter of vitreomacular adhesion based on spectral domain optical coherence tomography: Group 1 (14 eyes) focal attachment ≤1,500 μm; and Group 2 (eight eyes) broad attachment >1,500 μm.
Mean postoperative follow-up was 25.4 months (range, 6-68). The preoperative mean logarithm of the minimal angle of resolution visual acuity was 0.73 (20/107), which significantly improved to 0.49 (20/62) postoperatively (P < 0.01). Seventeen eyes (77%) had Snellen visual acuity improvement ≧ two lines, and nine eyes had improvement ≧ three lines. The improvement of visual acuity was significantly better in Group 1 than in Group 2 (2.7 lines vs. 0.8 lines) (P = 0.03). The preoperative mean central macular thickness was 563 μm ± 176 μm, which significantly improved to 298 μm ± 69 μm postoperatively (P < 0.01). In multivariate analysis, better final visual acuity was significantly associated with Group 1 VMT (P < 0.01) and with shorter symptom duration (P < 0.01). Greater improvement of visual acuity was also significantly associated with younger age of patients (P = 0.02) and with Group 1 VMT (P < 0.01). In linear regression analysis, patients with longer symptom duration had worse final visual acuity (β = 0.02) and patients of younger age had greater visual acuity improvement (β = 0.008).
Most patients of VMT gained significant functional and anatomical improvements after vitrectomy. Group 1 optical coherence tomography pattern, shorter symptom duration, and younger age are significant predictive factors of better visual outcome.
评估玻璃体黄斑牵引综合征（VMT）患者玻璃体切除术后的长期功能和解剖学结果，并分析与视力结果相关的预测因素。
回顾性连续病例系列研究了 22 例 22 只 VMT 患者，这些患者接受玻璃体切除术以减轻黄斑水肿。根据频域光相干断层扫描，根据玻璃体黄斑粘连的直径将眼分为两组：组 1（14 只眼）局灶性粘连≤1500μm；组 2（8 只眼）广泛粘连>1500μm。
平均术后随访时间为 25.4 个月（范围 6-68 个月）。术前最小分辨角视力对数均值为 0.73（20/107），术后显著提高至 0.49（20/62）（P<0.01）。17 只眼（77%）视力提高≧两行，9 只眼提高≧三行。组 1 的视力改善明显优于组 2（2.7 行比 0.8 行）（P=0.03）。术前平均中央黄斑厚度为 563μm±176μm，术后显著改善至 298μm±69μm（P<0.01）。多元分析显示，最终视力较好与 VMT 组 1（P<0.01）和较短的症状持续时间（P<0.01）显著相关。视力改善较大也与患者年龄较小（P=0.02）和 VMT 组 1 显著相关（P<0.01）。线性回归分析显示，症状持续时间较长的患者最终视力较差（β=0.02），年龄较小的患者视力改善较大（β=0.008）。
大多数 VMT 患者在玻璃体切除术后获得显著的功能和解剖改善。光学相干断层扫描组 1 模式、较短的症状持续时间和较小的年龄是视力较好的显著预测因素。
