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高度近视性黄斑劈裂的内界膜剥除联合气体填充术:一项系统评价与Meta分析

Internal limiting membrane peeling and gas tamponade for myopic foveoschisis: a systematic review and meta-analysis.

作者信息

Meng Bo, Zhao Lu, Yin Yi, Li Hongyang, Wang Xiaolei, Yang Xiufen, You Ran, Wang Jialin, Zhang Youjing, Wang Hui, Du Ran, Wang Ningli, Zhan Siyan, Wang Yanling

机构信息

Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Road., Xi-Cheng District, Beijing, 100050, China.

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

出版信息

BMC Ophthalmol. 2017 Sep 8;17(1):166. doi: 10.1186/s12886-017-0562-8.

Abstract

BACKGROUND

Myopic foveoschisis (MF) is among the leading causes of visual loss in high myopia. However, it remains controversial whether internal limiting membrane (ILM) peeling or gas tamponade is necessary treatment option for MF.

METHODS

PubMed, EMBASE, CBM, CNKI, WANFANG DATA and VIP databases were systematically reviewed. Outcome indicators were myopic foveoschisis resolution rate, visual acuity improvement and postoperative complications.

RESULTS

Nine studies that included 239 eyes were selected. The proportion of resolution of foveoschisis was higher in ILM peeling group than non-ILM peeling group (OR = 2.15, 95% CI: 1.06-4.35; P = 0.03). The proportion of postoperative complications was higher in Tamponade group than non-Tamponade group (OR = 10.81, 95% CI: 1.26-93.02; P = 0.03). However, the proportion of visual acuity improvement (OR = 1.63, 95% CI: 0.56-4.80; P = 0.37) between ILM peeling group and non-ILM peeling group and the proportion of resolution of foveoschisis (OR = 1.80, 95% CI: 0.76-4.28; P = 0.18) between Tamponade group and non-Tamponade group were similar.

CONCLUSIONS

Vitrectomy with internal limiting membrane peeling could contribute to better resolution of myopic foveoschisis than non-peeling, however it does not significantly influence the proportion of visual acuity improvement and postoperative complications. Vitrectomy with gas tamponade is associated with more complications than non-tamponade and does not significantly influence the proportion of visual acuity improvement and resolution of myopic foveoschisis.

摘要

背景

近视性黄斑劈裂(MF)是高度近视导致视力丧失的主要原因之一。然而,对于MF而言,内界膜(ILM)剥除术或气体填充术是否为必要的治疗选择仍存在争议。

方法

对PubMed、EMBASE、CBM、CNKI、万方数据和维普数据库进行系统综述。结局指标为近视性黄斑劈裂的愈合率、视力改善情况及术后并发症。

结果

共纳入9项研究,涉及239只眼。ILM剥除组黄斑劈裂的愈合比例高于非ILM剥除组(OR = 2.15,95%CI:1.06 - 4.35;P = 0.03)。填充组术后并发症的比例高于非填充组(OR = 10.81,95%CI:1.26 - 93.02;P = 0.03)。然而,ILM剥除组与非ILM剥除组之间视力改善的比例(OR = 1.63,95%CI:0.56 - 4.80;P = 0.37)以及填充组与非填充组之间黄斑劈裂的愈合比例(OR = 1.80,95%CI:0.76 - 4.28;P = 0.18)相似。

结论

与未进行剥除的玻璃体切除术相比,内界膜剥除的玻璃体切除术有助于更好地解决近视性黄斑劈裂,但对视力改善比例和术后并发症无显著影响。与非填充的玻璃体切除术相比,气体填充的玻璃体切除术并发症更多,且对视力改善比例和近视性黄斑劈裂的愈合无显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/624b/5591565/3d99f3cde5bc/12886_2017_562_Fig1_HTML.jpg

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