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治疗后的视网膜裂孔:临床病程及预后

Treated retinal breaks: clinical course and outcomes.

作者信息

Garoon Robert B, Smiddy William E, Flynn Harry W

机构信息

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, 900 NW 17th St., Miami, FL, 33136, USA.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2018 Jun;256(6):1053-1057. doi: 10.1007/s00417-018-3950-8. Epub 2018 Mar 9.

Abstract

PURPOSE

To report rates and timing of retreatments, new break formation, and vitreoretinal surgical intervention after initial treatment of retinal breaks, and to identify factors associated with increased rates of additional vitreoretinal interventions.

METHODS

Retrospective, consecutive case series of all patients who were diagnosed with a retinal break and underwent laser retinopexy for prophylaxis of retinal detachment at the Bascom Palmer Eye Institute, Miami, FL, from 2013 through 2016 were reviewed. The main outcome measure was if additional laser treatment or vitreoretinal surgical procedure was performed after the initial laser retinopexy.

RESULTS

Additional laser retinopexy was performed in 75 (18.7%) of 401 study eyes over 113 sessions: 58 (51.3%) sessions to retreat the original tear and 55 (48.7%) to treat a new tear. Vitreoretinal surgery for retinal detachment after the initial laser retinopexy was performed in 23 (5.7%) eyes. Risk factors associated with vitreoretinal surgery after initial laser treatment included superotemporal location (OR = 3.62; p = 0.008), vitreous hemorrhage (OR = 2.62; p = 0.017), and multiple breaks (OR = 2.60; p = 0.014).

CONCLUSIONS

Additional treatment is often performed after the initial treatment of a retinal break. Although progression to retinal detachment is not common, regular follow-up examinations are recommended.

摘要

目的

报告视网膜裂孔初次治疗后再次治疗的发生率及时间、新裂孔形成情况以及玻璃体视网膜手术干预情况,并确定与额外玻璃体视网膜干预发生率增加相关的因素。

方法

回顾性、连续性病例系列研究,纳入2013年至2016年在佛罗里达州迈阿密巴斯科姆帕尔默眼科研究所被诊断为视网膜裂孔并接受激光视网膜光凝预防视网膜脱离的所有患者。主要观察指标为初次激光视网膜光凝后是否进行额外的激光治疗或玻璃体视网膜手术。

结果

401只研究眼中,75只(18.7%)在113次治疗中接受了额外的激光视网膜光凝:58次(51.3%)用于治疗原裂孔,55次(48.7%)用于治疗新裂孔。初次激光视网膜光凝后,23只(5.7%)眼因视网膜脱离接受了玻璃体视网膜手术。初次激光治疗后与玻璃体视网膜手术相关的危险因素包括颞上象限裂孔(比值比[OR]=3.62;P=0.008)、玻璃体积血(OR=2.62;P=0.017)和多个裂孔(OR=2.60;P=0.014)。

结论

视网膜裂孔初次治疗后常需进行额外治疗。虽然进展为视网膜脱离并不常见,但仍建议定期进行随访检查。

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