Zarifa Aliyeva National Ophthalmology Centre, 32/15 Javadkhan str., Baku, AZ1114, Azerbaijan.
Eye (Lond). 2018 Sep;32(9):1472-1477. doi: 10.1038/s41433-018-0111-6. Epub 2018 May 23.
To analyze the prevalence of residual subfoveal fluid (RSF) after pars plana vitrectomy in patients with proliferative diabetic retinopathy complicated by tractional detachment of the macula and the effect of RSF on the postoperative visual outcome.
This study was a prospective observational case study of the optical coherence tomography (OCT) records of 23 patients (24 eyes) with macula-off diabetic tractional retinal detachment (TRD) who underwent successful 23-gauge pars plana vitrectomy between July 2012 and December 2015.
The prevalence of RSF on OCT examination was 100% at 1 and 2 months, 91.7% at 3 months, 70.8% at 6 months, 25.0% at 9 months and 4.2% at 12 months after surgery (p < 0.001). Internal drainage of subretinal fluid (SRF) during primary surgery was performed in 13 (54.2%) eyes. The significant risk factor that was predictive of long-standing RSF was non-drainage of SRF (p = 0.04).
Persistent RSF is a common OCT finding after clinically successful vitrectomy surgery for the treatment of macula-off diabetic tractional retinal detachment. Internal drainage of SRF with active aspiration can be attempted if intraoperative breaks are found or if faster recovery is required. To date, observation seems to be the best option.
分析增殖性糖尿病视网膜病变伴黄斑牵拉性脱离行玻璃体切除术患者术后残留黄斑下液（RSF）的发生率及 RSF 对术后视力结果的影响。
本研究为前瞻性观察性病例研究，纳入 2012 年 7 月至 2015 年 12 月期间成功接受 23G 经睫状体平坦部玻璃体切除术治疗的 23 例（24 只眼）黄斑脱离型糖尿病牵拉性视网膜脱离患者的光学相干断层扫描（OCT）记录。
术后 1 个月和 2 个月 OCT 检查 RSF 发生率均为 100%，3 个月时为 91.7%，6 个月时为 70.8%，9 个月时为 25.0%，12 个月时为 4.2%（p<0.001）。13 只眼（54.2%）在初次手术中进行了视网膜下液（SRF）内引流。SRF 未引流是预测 RSF 持续存在的显著危险因素（p=0.04）。
在成功治疗黄斑脱离型糖尿病牵拉性视网膜脱离的玻璃体切除术后，持续性 RSF 是一种常见的 OCT 发现。如果术中发现裂孔或需要更快恢复，可以尝试进行 SRF 内引流并积极抽吸。到目前为止，观察似乎是最佳选择。
