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根据近视性黄斑病变的国际照相分类,近视牵引性黄斑病变的手术结果。

SURGICAL OUTCOMES OF MYOPIC TRACTION MACULOPATHY ACCORDING TO THE INTERNATIONAL PHOTOGRAPHIC CLASSIFICATION FOR MYOPIC MACULOPATHY.

机构信息

Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Retina. 2020 Aug;40(8):1492-1499. doi: 10.1097/IAE.0000000000002642.

Abstract

PURPOSE

To compare treatment results of myopic traction maculopathy according to the international photographic classification for myopic maculopathy.

METHODS

This was a retrospective, single-surgeon-based, observational case series of 35 consecutive eyes that underwent vitrectomy for myopic traction maculopathy. Eyes were classified into nonpathologic myopia (PM) (n = 15) and PM (n = 20) groups. Main outcome measures constituted best-corrected visual acuity (BCVA) and anatomical change.

RESULTS

The mean follow-up was 32.03 ± 6.85 months. Axial length correlated with myopic maculopathy category (rho = 0.6836, P < 0.001). In the total group, BCVA improved from 20/61 to 20/36 (P = 0.001). In the subgroup, BCVA improved from 20/41 to 20/22 in the non-PM group (P = 0.002), whereas from 20/82 to 20/52 in the PM group (P = 0.048). Postoperative BCVA of the PM group was inferior to that of the non-PM group (P = 0.002) and the PM group was more likely to have postoperative BCVA <20/30 (odds ratio, 17.3; 95% CI, 2.6-325.0; P = 0.012). Two cases of macular hole retinal detachment occurred after surgery in the PM group.

CONCLUSION

Because there are limited benefits of vitrectomy in myopic traction maculopathy accompanied by PM, careful consideration would be necessary when determining surgery. Optical coherence tomography should not be used alone in determining vitrectomy because myopic traction maculopathy can also have PM defined mainly by fundus photographs.

摘要

目的

根据国际近视性黄斑病变照相分类法,比较近视牵引性黄斑病变的治疗结果。

方法

这是一项回顾性、单医生、观察性的连续 35 例接受玻璃体切割术治疗近视牵引性黄斑病变的病例系列研究。将眼分为非病理性近视(PM)(n = 15)和 PM(n = 20)组。主要观察指标为最佳矫正视力(BCVA)和解剖学变化。

结果

平均随访时间为 32.03 ± 6.85 个月。眼轴与近视性黄斑病变分类相关(rho = 0.6836,P < 0.001)。在总组中,BCVA 从 20/61 提高到 20/36(P = 0.001)。在亚组中,非 PM 组 BCVA 从 20/41 提高到 20/22(P = 0.002),而 PM 组从 20/82 提高到 20/52(P = 0.048)。PM 组术后 BCVA 低于非 PM 组(P = 0.002),且 PM 组术后 BCVA <20/30 的可能性更高(优势比,17.3;95%置信区间,2.6-325.0;P = 0.012)。PM 组术后有 2 例黄斑裂孔视网膜脱离。

结论

由于伴有 PM 的近视牵引性黄斑病变玻璃体切割术的获益有限,在决定手术时需要谨慎考虑。光相干断层扫描不应单独用于确定玻璃体切除术,因为近视牵引性黄斑病变也可能有主要由眼底照片定义的 PM。

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