Fukumoto Masanori, Sato Takaki, Oosuka Shou, Kida Teruyo, Oku Hidehiro, Ikeda Tsunehiko
Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan.
Clin Ophthalmol. 2020 Jan 28;14:281-286. doi: 10.2147/OPTH.S235670. eCollection 2020.
To retrospectively review and analyze the clinical and imaging data of patients with vitreomacular traction syndrome (VMTS) with strong peripheral vitreoretinal adhesion.
This retrospective case-series study involved 4 eyes of 4 VMTS patients with vitreoretinal adhesion in both the macular region and the periphery who underwent vitreous surgery. In all 4 cases, preoperative refraction, fundoscopic findings, optical coherence tomography (OCT) findings, and intraoperative findings were evaluated.
The preoperative fundoscopy and OCT findings revealed fibrous membranes around the optic nerve head in 3 eyes. Thickened posterior vitreous membranes extending from the posterior pole to the periphery were observed in all eyes. Apparent VMTS or epimacular membrane was also found in the fellow eyes of 2 patients. The preoperative refractive errors ranged from +0.5 diopters (D) to +2.75 D (mean, +1.13 D). Intraoperatively, a thickened posterior vitreous membrane was found strongly adhered to the retina in the macula regions, optic nerve head, and periphery. In 2 eyes, when artificial posterior vitreous detachment (PVD) was created, an iatrogenic tear developed in the periphery.
The features of VMTS that cause strong peripheral vitreoretinal adhesion include the preoperative presence of a thickened posterior vitreous membrane over a wide area, hypermetropia, and a short axial length.
回顾性分析伴有周边玻璃体视网膜强粘连的玻璃体黄斑牵引综合征（VMTS）患者的临床及影像学资料。
本回顾性病例系列研究纳入4例VMTS患者的4只眼，这些患者黄斑区及周边均存在玻璃体视网膜粘连，并接受了玻璃体手术。对所有4例患者的术前验光、眼底检查结果、光学相干断层扫描（OCT）结果及术中所见进行评估。
术前眼底检查和OCT检查发现，3只眼的视神经乳头周围有纤维膜。所有眼中均观察到从后极延伸至周边的增厚的玻璃体后界膜。在2例患者的对侧眼中还发现了明显的VMTS或黄斑前膜。术前屈光不正范围为+0.5屈光度（D）至+2.75 D（平均，+1.13 D）。术中发现增厚的玻璃体后界膜在黄斑区、视神经乳头及周边与视网膜紧密粘连。2只眼中，在制造人工玻璃体后脱离（PVD）时，周边出现医源性裂孔。
导致周边玻璃体视网膜强粘连的VMTS特征包括术前存在广泛增厚的玻璃体后界膜、远视及眼轴短。
