玻璃体切除术联合内界膜剥除术后近视性黄斑劈裂不同光学相干断层扫描模式的形态学和功能结果
Morphologic and functional outcomes of different optical coherence tomography patterns of myopic foveoschisis after vitrectomy and inner limiting membrane peeling.
作者信息
Sborgia Giancarlo, Boscia Francesco, Niro Alfredo, Giancipoli Ermete, D'Amico Ricci Giuseppe, Sborgia Alessandra, Sborgia Luigi, Recchimurzo Nicola, Romano Mario R, Addabbo Giuseppe, Alessio Giovanni
机构信息
Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy.
Department of Surgical, Microsurgical and Medical Sciences, Eye Clinic, University of Sassari, Sassari, Italy.
出版信息
Eye (Lond). 2019 Nov;33(11):1768-1775. doi: 10.1038/s41433-019-0490-3. Epub 2019 Jun 17.
OBJECTIVE
To evaluate the morphologic and functional outcomes of different optical coherence tomography (OCT) patterns of myopic foveoschisis after vitrectomy with Inner Limiting Membrane (ILM) peeling.
METHODS
In this prospective non-randomised study, 62 consecutive eyes with Myopic Foveoschisis were categorised into three groups according to OCT pattern: retinoschisis type (Rt) Group (23/62), foveal detachment type (FDt) Group (20/62) and macular hole type (MHt) Group (19/62). All patients underwent 25-Gauge vitrectomy and ILM peeling. Air or gas tamponade was used. All patients were observed at month 1, 2, 4 and 6 after surgery.
MAIN OUTCOMES MEASURES
surgical success as resolution of myopic foveoschisis, central retinal thickness (CRT), IS/OS junction recovery and best-corrected visual acuity (BCVA) measurement. Any complication was reported.
RESULTS
In all eyes OCT showed a resolution of the retinoschisis, foveal detachment and macular hole pattern, respectively. CRT significantly decreased in all Groups (p < .001), mainly in MHt. IS/OS junction recovery was mainly observed in MHt. BCVA significantly increased in all Groups (p < .01). A functional gain ≥2 Snellen lines occurred in 70, 85 and 68% in the Rt, FDt and MHt Group, respectively. Final BCVA was correlated with preoperative BCVA (R 0.74, p < 0.0001), postoperative CRT (R -0.49, p < 0.0001), and the recovery of IS/OS junction at 6 months (R 0.76, p < 0.0001). Few postoperative complications occurred.
CONCLUSIONS
Vitrectomy with ILM peeling results in favourable anatomic and functional outcomes for different patterns of myopic foveoschisis.
目的
评估玻璃体切割联合内界膜（ILM）剥除术后不同光学相干断层扫描（OCT）模式的近视性黄斑劈裂的形态学和功能学转归。
方法
在这项前瞻性非随机研究中，62例连续的近视性黄斑劈裂患者根据OCT模式分为三组：视网膜劈裂型（Rt）组（23/62）、黄斑脱离型（FDt）组（20/62）和黄斑裂孔型（MHt）组（19/62）。所有患者均接受25G玻璃体切割及ILM剥除术。使用空气或气体填充。所有患者在术后1、2、4和6个月进行观察。
主要观察指标
近视性黄斑劈裂的消退情况、中心视网膜厚度（CRT）、IS/OS连接的恢复情况以及最佳矫正视力（BCVA）测量。报告任何并发症。
结果
所有患眼的OCT分别显示视网膜劈裂、黄斑脱离和黄斑裂孔模式消退。所有组的CRT均显著降低（p < 0.001），主要是在MHt组。IS/OS连接的恢复主要见于MHt组。所有组的BCVA均显著提高（p < 0.01）。Rt组、FDt组和MHt组分别有70%、85%和68%的患者功能增益≥2行Snellen视力表。最终BCVA与术前BCVA相关（R 0.74，p < 0.0001）、术后CRT相关（R -0.49，p < 0.0001）以及术后6个月IS/OS连接的恢复情况相关（R 0.76，p < 0.0001）。术后并发症较少。
结论
玻璃体切割联合ILM剥除术对不同模式的近视性黄斑劈裂可产生良好的解剖学和功能学转归。
Zotero 插件