Department of Ophthalmology, Hospital de Santa Maria, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Vision Sciences Study Center, CECV, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Retin Cases Brief Rep. 2021 Mar 1;15(2):110-113. doi: 10.1097/ICB.0000000000000757.
There are currently limited data addressing the surgical outcomes of pars plana vitrectomy (PPV) in toxoplasmosis-related macular hole (tMH). We aim to report and discuss safety and efficacy of PPV for tMH.
Surgical case series (n = 11), with minimum postoperative follow-up time of 6 months. Consecutive patients who underwent PPV for tMH from 2013 to 2016 were included. Indications for surgery were: visual acuity ≥ 0.6 logarithm of the minimum angle of resolution (Snellen 20/80 or less), no intraocular inflammation for more than 6 months, extrafoveal toxoplasmosis scar, elevated tMH borders on optical coherence tomography, and patient agreement with surgery. Surgery was performed-PPV with epiretinal (if present) and internal limiting membrane peeling. Safety and efficacy of PPV for tMH were addressed by evaluating: 1) surgery-related complications and 2) visual acuity improvement.
A total of 11 patients (6 male), with a mean age of 33.2 ± 11.0 years were studied. Mean preoperative best-corrected visual acuity significantly improved from 1.10 ± 0.24 (Snellen 20/252) to 0.43 ± 0.18 logarithm of the minimum angle of resolution (Snellen 20/54) at last follow-up visit (P < 0.01). The rate of visual acuity improvement (i.e., a gain of at least three lines) and tMH closure was 100% for both. The only reported surgery-related complication was cataract in one case.
Our results suggest that PPV is a safe and effective option in tMH cases. A controlled, longitudinal study would contribute to confirm these findings.
目前有关弓形虫相关性黄斑裂孔(tMH)行玻璃体切除术(PPV)的手术结果数据有限。我们旨在报告和讨论 PPV 治疗 tMH 的安全性和有效性。
这是一项手术病例系列研究(n=11),术后随访时间最短为 6 个月。纳入 2013 年至 2016 年间因 tMH 行 PPV 的连续患者。手术适应证为:视力≥0.6 对数最小角分辨率(Snellen 20/80 或更差),眼内炎症持续时间超过 6 个月,旁中心弓形虫瘢痕,光学相干断层扫描显示黄斑裂孔边界抬高,以及患者同意手术。手术方法为:行 PPV 联合视网膜前膜(如有)和内界膜剥除。通过评估:1)手术相关并发症和 2)视力改善,来确定 PPV 治疗 tMH 的安全性和有效性。
共纳入 11 例患者(6 例男性),平均年龄为 33.2±11.0 岁。平均术前最佳矫正视力从 1.10±0.24(Snellen 20/252)显著改善至 0.43±0.18 对数最小角分辨率(Snellen 20/54),末次随访时差异有统计学意义(P<0.01)。视力提高(即提高至少三行)和黄斑裂孔闭合的发生率均为 100%。唯一报告的手术相关并发症为 1 例白内障。
我们的结果表明,PPV 是 tMH 患者的安全有效选择。一项对照、前瞻性研究将有助于证实这些发现。