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微视野计测量近视性黄斑视网膜劈裂行保留中心凹内界膜剥除术后的功能和结构转归

FUNCTIONAL AND STRUCTURAL OUTCOMES AFTER FOVEA-SPARING INTERNAL LIMITING MEMBRANE PEELING FOR MYOPIC MACULAR RETINOSCHISIS BY MICROPERIMETRY.

机构信息

Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan; and.

Musashino Red-Cross Hospital, Musashino, Japan.

出版信息

Retina. 2020 Aug;40(8):1500-1511. doi: 10.1097/IAE.0000000000002627.

Abstract

PURPOSE

To determine the morphological and physiological outcomes and safety of vitrectomy with fovea-sparing internal limiting membrane peeling for myopic macular retinoschisis (MRS).

METHODS

Highly myopic eyes (refractive error greater than -8.0 diopters or an axial length longer than 26.5 mm) with MRS that underwent vitrectomy with fovea-sparing internal limiting membrane peeling were analyzed retrospectively. The best-corrected visual acuity, retinal morphology, and the central and paracentral retinal sensitivities at 2°/6° by microperimetry were evaluated before and after the surgery. Postoperative microscotomas were also determined.

RESULTS

Thirty-three eyes with MRS; 16 eyes with and 17 eyes without a foveal retinal detachment, were studied. All 33 eyes had an improvement of MRS and foveal retinal detachment partially or completely after surgery, and none developed a full thickness macular hole. The postoperative best-corrected visual acuity, the central retinal sensitivity, and the retinal sensitivity at 2° were significantly better than the preoperative values. Sixteen eyes developed postoperative microscotomas at paracentral 2° and/or 6°.

CONCLUSION

The results showed that vitrectomy with fovea-sparing internal limiting membrane peeling is an effective and safe method to treat an MRS regardless of the presence of a foveal retinal detachment. However, careful follow-up should be performed to detect postoperative microscotomas.

摘要

目的

观察保留中心凹的内界膜剥除术治疗近视性黄斑劈裂(MRS)的形态学和生理学转归及安全性。

方法

回顾性分析了行保留中心凹的内界膜剥除术的高度近视(屈光不正>-8.0 屈光度或眼轴长度>26.5mm)伴 MRS 患者的临床资料。比较术前和术后最佳矫正视力、视网膜形态以及微视野计测量的中央和旁中心视网膜敏感度。

结果

33 只眼伴 MRS,其中 16 只眼合并中心凹视网膜脱离,17 只眼不合并中心凹视网膜脱离。所有患眼的 MRS 和部分或完全性中心凹视网膜脱离在术后均得到改善,无全层黄斑裂孔形成。术后最佳矫正视力、中央视网膜敏感度和 2°处视网膜敏感度均较术前显著提高。16 只眼术后在旁中心 2°和/或 6°出现微视野缺损。

结论

结果表明,保留中心凹的内界膜剥除术是治疗 MRS 的一种有效且安全的方法,无论是否合并中心凹视网膜脱离。然而,应密切随访以发现术后微视野缺损。

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