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糖尿病性视网膜病变中的板层黄斑裂孔。

Lamellar macular hole in diabetic retinopathy.

机构信息

Department of Ophthalmology, National Taiwan University Hospital, Taipei.

Department of Ophthalmology, Taipei City Hospital, Renai Branch, Taipei.

出版信息

Eur J Ophthalmol. 2021 Jan;31(1):166-172. doi: 10.1177/1120672119879665. Epub 2019 Oct 9.

Abstract

PURPOSE

To describe the clinical features and surgical outcomes of diabetic retinopathy-associated lamellar macular hole and compare them with those of idiopathic lamellar macular hole.

METHODS

A total of 17 eyes with diabetic retinopathy-associated lamellar macular hole and 30 eyes with idiopathic lamellar macular hole undergoing surgery were retrospectively enrolled. Baseline best-corrected visual acuity, preoperative optical coherence tomography characteristics, and final best-corrected visual acuity were compared between two groups.

RESULTS

Both the baseline and the final best-corrected visual acuity in the diabetic retinopathy group were significantly worse than those in the idiopathic group (p = 0.029 for baseline, p = 0.002 for final). Lamellar macular hole in diabetic retinopathy tended to have a wider opening (p < 0.001) and a thinner residual base (p = 0.023). The width and height of parafoveal schisis in diabetic retinopathy-associated lamellar macular hole were both larger than those in idiopathic lamellar macular hole (p < 0.001 for both). After operation, both groups achieved significant improvement in best-corrected visual acuity (p < 0.01 for both).

CONCLUSION

Compared with idiopathic group, diabetic retinopathy-associated lamellar macular hole had worse baseline best-corrected visual acuity, wider defect, and more pronounced parafoveal schisis. However, significant visual improvement could be obtained after operation. All cases in both groups achieved good anatomical outcomes with normalization of foveal contour and reduction of parafoveal schisis.

摘要

目的

描述糖尿病性视网膜病变相关板层黄斑裂孔的临床特征和手术结果,并与特发性板层黄斑裂孔进行比较。

方法

回顾性纳入 17 只患有糖尿病性视网膜病变相关板层黄斑裂孔的眼和 30 只患有特发性板层黄斑裂孔的眼。比较两组的基线最佳矫正视力、术前光学相干断层扫描特征和最终最佳矫正视力。

结果

糖尿病组的基线和最终最佳矫正视力均明显差于特发性组(p=0.029 基线,p=0.002 最终)。糖尿病性板层黄斑裂孔的裂孔开口较宽(p<0.001),残余底部较薄(p=0.023)。糖尿病性板层黄斑裂孔相关的黄斑劈裂的旁中心凹裂孔的宽度和高度均大于特发性板层黄斑裂孔(两者均为 p<0.001)。术后两组最佳矫正视力均显著提高(两者均为 p<0.01)。

结论

与特发性组相比,糖尿病性视网膜病变相关板层黄斑裂孔的基线最佳矫正视力更差,裂孔更大,旁中心凹劈裂更明显。然而,术后可以获得明显的视力改善。两组所有病例均获得良好的解剖学结果,即黄斑中心凹轮廓正常,旁中心凹劈裂减少。

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