高度近视黄斑裂孔性视网膜脱离行硅油原发性填塞的长期随访：预后因素分析。

Long-term follow-up of primary silicone oil tamponade for retinal detachment secondary to macular hole in highly myopic eyes: a prognostic factor analysis.

机构信息

Department of Ophthalmology, Peking University People's Hospital; Eye diseases and optometry institute; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, 100044, Beijing, China.

出版信息

Eye (Lond). 2021 Feb;35(2):625-631. doi: 10.1038/s41433-020-0922-0. Epub 2020 May 6.

DOI:10.1038/s41433-020-0922-0

PMID:32376975

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8027595/

Abstract

PURPOSE

To investigate the risk factors associated with retinal detachment recurrence after first vitrectomy in high myopic eyes with macular hole retinal detachment (MHRD).

METHODS

Patients with high myopic eyes with MHRD who underwent pars plana vitrectomy and silicone oil (SO) tamponade with a follow-up period more than 12 months and more than 3 months after SO removal were included in this retrospective study. Logistic regression was performed to determine the risk factors associated with retinal re-detachment.

RESULTS

A total of 45 eyes from 43 patients were included in this study (11 male and 34 female patients). The retinal re-detachment rate after the first removal of silicon oil was 35.5% (16/45) in a mean postoperative follow-up time of 35.64 ± 32.94 months. Complete macular atrophy on fundus photography (odds ratio (OR) = 17.021, 95% confidence interval (95% CI): 2.218-130.609, p = 0.006) was a risk factor for MHRD after SO removal, while internal limiting membrane (ILM) peeling (OR = 0.091, 95% CI: 0.013-0.633, p = 0.015) and duration of SO tamponade (OR = 0.667, 95% CI: 0.454-0.980, p = 0.039) were protective factors.

CONCLUSION

For high myopic eyes with MHRD, complete macular atrophy was a significant risk factor for retinal re-detachment after silicon oil removal. ILM peeling and the duration of silicon oil tamponade were protective factors.

摘要

目的

探讨高度近视合并黄斑孔视网膜脱离（MHRD）患者首次玻璃体切除术后视网膜脱离复发的相关危险因素。

方法

回顾性分析行标准三通道经睫状体平坦部玻璃体切割联合硅油（SO）填充术，随访时间超过 12 个月，SO 取出后随访时间超过 3 个月的高度近视合并 MHRD 患者的临床资料。采用 Logistic 回归分析视网膜脱离复发的相关危险因素。

结果

本研究共纳入 43 例 45 眼患者（男 11 例，女 34 例）。术后平均随访 35.64±32.94 个月，首次 SO 取出后视网膜再脱离率为 35.5%（16/45）。眼底照相检查发现完全性黄斑萎缩是 SO 取出后 MHRD 的危险因素（优势比（OR）=17.021，95%置信区间（95%CI）：2.218-130.609，p=0.006），内界膜（ILM）剥除（OR=0.091，95%CI：0.013-0.633，p=0.015）和 SO 填充时间（OR=0.667，95%CI：0.454-0.980，p=0.039）是保护性因素。