Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Zhongzheng District, Taipei, Taiwan.
College of Medicine, National Taiwan University, No. 1, Section 1, Ren-Ai Road, Zhongzheng District, Taipei, Taiwan.
Eye (Lond). 2020 Feb;34(2):392-399. doi: 10.1038/s41433-019-0555-3. Epub 2019 Aug 12.
To evaluate the long-term results of gas tamponade without vitrectomy in patients with myopic foveoschisis (FS) and foveal detachment (FD).
Twenty eyes of 20 patients with myopic foveoschisis and foveal detachment were analysed retrospectively. All patients received an intravitreal injection of 0.2-0.3 mL C3F8 as an initial treatment. The patients were followed up for at least 18 months after the procedure. The refractive status, best-corrected visual acuity (BCVA), and anatomical abnormalities in macular area before and after the treatment were assessed and recorded.
After initial gas tamponade, FD resolved completely (defined as responders) in 14 eyes, resolved partially in 2 eyes (defined as partial responders), and worsened in 4 eyes (non-responders) at the 3-month follow-up visit. Vitrectomy was performed in four eyes that showed increased detachment (two cases) or developed macular hole (two cases). Repeated gas injection was performed in two recurrent cases after initial success at the 3-month follow-up, and the foveal detachment once again resolved. Overall, 70% of our cases demonstrated resolution of FD at the 3-month follow-up and the long-term responders to gas injection was 65%. The risk factors for treatment failure were: (1) The presence of optical coherence tomography (OCT)-evident premacular membranes (p = 0.03) and (2) the height of FS measured >588 µm (p = 0.009).
Our data supported that gas tamponade may be effective as an alternative treatment for selected cases of myopic FS with FD. The procedure may be especially beneficial in patients without OCT-evident premacular membranes and have low height of FS.
评估单纯气体填充治疗近视性黄斑劈裂伴黄斑脱离（FS/FD）的长期疗效。
回顾性分析 20 例（20 只眼）近视性黄斑劈裂伴黄斑脱离患者的临床资料。所有患者均接受了 0.2-0.3ml 的 C3F8 玻璃体腔注气治疗。术后随访 18 个月以上，观察并记录患者的屈光状态、最佳矫正视力（BCVA）和黄斑区解剖学变化。
初次注气后，3 个月时，14 只眼的 FD 完全复位（完全缓解），2 只眼部分缓解，4 只眼（无反应）加重。其中 4 只眼因脱离加重或出现黄斑裂孔行玻璃体切割术。初次注气后 3 个月时 2 只眼再次出现 FD 复发，再次行注气治疗后 FD 均复位。总的来说，70%的患者在 3 个月时 FD 完全复位，长期完全缓解率为 65%。治疗失败的相关因素为：（1）OCT 可见黄斑前膜（p=0.03）；（2）黄斑劈裂高度＞588μm（p=0.009）。
单纯气体填充治疗近视性黄斑劈裂伴 FD 是一种有效的治疗方法，尤其是对于无黄斑前膜、黄斑劈裂高度较低的患者。
