Kim Jong Min, Lee Eun Jung, Cho Ga Eun, Bae Kunho, Lee Ju Yeun, Han Gyule, Kang Se Woong
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2017 Oct;31(5):402-411. doi: 10.3341/kjo.2016.0033. Epub 2017 Sep 11.
The aim of this study was to investigate the incidence and associated clinical factors of delayed absorption of subretinal fluid (SRF) after surgery for rhegmatogenous retinal detachment.
This study involved 36 eyes of 36 consecutive patients who underwent successful surgery for rhegmatogenous retinal detachment. A complete ophthalmologic evaluation, including clinical fundus examination, optical coherence tomography, and indocyanine green angiography, was conducted before and after surgery. Delayed absorption was defined as the presence of residual concave SRF or an SRF bleb at 6 months after surgery. Clinical factors and choroidal features on indocyanine green angiography were compared according to the presence and absence of delayed absorption.
Eighteen of 36 eyes (50%) showed delayed absorption. Macular involvement and worse preoperative visual acuity were significantly related to the presence of delayed absorption (p = 0.001 and p = 0.034, respectively). On indocyanine green angiography, preoperative choroidal vascular hyperpermeability was noted in 70% of eyes with delayed absorption and in 14% of eyes without it (p = 0.010).
Delayed absorption of SRF after retinal reattachment surgery was not rare, with a 50% of incidence in this study. Macula-off status was significantly related to the incidence of delayed SRF absorption, and choroidal features such as choroidal vascular hyperpermeability might be responsible in part, possibly through the resultant exudative property of choroid.
本研究旨在调查孔源性视网膜脱离手术后视网膜下液(SRF)吸收延迟的发生率及相关临床因素。
本研究纳入了36例连续接受孔源性视网膜脱离成功手术的患者的36只眼。在手术前后进行了全面的眼科评估,包括临床眼底检查、光学相干断层扫描和吲哚菁绿血管造影。吸收延迟定义为术后6个月存在残留的凹形SRF或SRF泡。根据是否存在吸收延迟,比较临床因素和吲哚菁绿血管造影上的脉络膜特征。
36只眼中有18只眼(50%)出现吸收延迟。黄斑受累和术前视力较差与吸收延迟的存在显著相关(分别为p = 0.001和p = 0.034)。在吲哚菁绿血管造影上,70%有吸收延迟的眼中术前脉络膜血管通透性增高,而无吸收延迟的眼中这一比例为14%(p = 0.010)。
视网膜复位手术后SRF吸收延迟并不罕见,本研究中的发生率为50%。黄斑脱离状态与SRF吸收延迟的发生率显著相关,脉络膜血管通透性增高等脉络膜特征可能部分起作用,可能是通过脉络膜产生的渗出特性。