Kobayashi Misato, Iwase Takeshi, Yamamoto Kentaro, Ra Eimei, Murotani Kenta, Terasaki Hiroko
Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan.
PLoS One. 2017 Sep 13;12(9):e0184783. doi: 10.1371/journal.pone.0184783. eCollection 2017.
To determine the perioperative factors that are significantly correlated with the final visual acuity following reattachment of a macula-off rhegmatogenous retinal detachment (RRD) by vitrectomy.
Twenty-nine eyes of 29 patients with a successfully reattached RRD by vitrectomy were retrospectively analyzed. Spectral-domain optical coherence tomographic images of the macular regions were used to measure the thicknesses of the retinal layers and the integrity of the microstructures of the photoreceptors at 2 weeks, 1, 2, 3, 6, 9, and 12 months following the vitrectomy. The best-corrected visual acuities (BCVA) were evaluated at the same times.
The improvement of the BCVA from the preoperative BCVA to that at postoperative Week 2 (-0.67 ± 0.69 logMAR units) was the largest change between adjacent observation periods for the entire study duration. It was significantly greater than the improvement between Week 2 and Month 12 (-0.32 ± 0.22 logMAR units; P<0.001). The thickness of the ellipsoid zone (EZ)-retinal pigment epithelium (RPE) increased significantly with time (P<0.001). The final BCVA was significantly correlated with the BCVA at Week 2 (r = 0.61, P<0.001), the EZ-RPE thickness at Week 2 (r = -0.40, P = 0.035), the integrity of the external limiting membrane (ELM) (r = -0.61, P = 0.003), and an intact EZ (r = -0.66, P = 0.001) at Week 2. Multiple stepwise regression analyses of the final BCVA showed that the BCVA at Week 2 (P = 0.017) and the integrity of the EZ at Week 2 (P = 0.006) were independent predictors of the final BCVA.
The significantly better BCVA and presence of an intact EZ at 2 weeks following vitrectomy and their significant correlations with the BCVA at Month 12 indicate that these perioperative values can be used to predict the BCVA at Month 12 after a reattachment of macula-off RRD following vitrectomy.
确定与玻璃体切除术后黄斑脱离的孔源性视网膜脱离（RRD）复位术后最终视力显著相关的围手术期因素。
回顾性分析29例经玻璃体切除术成功复位RRD患者的29只眼。使用黄斑区的光谱域光学相干断层扫描图像测量玻璃体切除术后2周、1、2、3、6、9和12个月时视网膜各层的厚度以及光感受器微结构的完整性。同时评估最佳矫正视力（BCVA）。
在整个研究期间，相邻观察期之间BCVA从术前到术后第2周（-0.67±0.69 logMAR单位）的改善是最大变化。它显著大于第2周和第12个月之间的改善（-0.32±0.22 logMAR单位；P<0.001）。椭圆体带（EZ）-视网膜色素上皮（RPE）的厚度随时间显著增加（P<0.001）。最终BCVA与术后第2周的BCVA（r = 0.61，P<0.001）、第2周的EZ-RPE厚度（r = -0.40，P = 0.035）、外限制膜（ELM）的完整性（r = -0.61，P = 0.003）以及第2周时完整的EZ（r = -0.66，P = 0.001）显著相关。最终BCVA的多元逐步回归分析表明，术后第2周的BCVA（P = 0.017）和第2周时EZ的完整性（P = 0.006）是最终BCVA的独立预测因素。
玻璃体切除术后2周时显著更好的BCVA以及完整EZ的存在，以及它们与第12个月时BCVA的显著相关性表明，这些围手术期值可用于预测玻璃体切除术后黄斑脱离RRD复位术后第12个月时的BCVA。
