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玻璃体腔内注射后孔源性视网膜脱离

Rhegmatogenous Retinal Detachment after Intravitreal Injection.

作者信息

Brown Karen R, Yannuzzi Nicolas A, Smiddy William E, Gregori Ninel Z, Berrocal Audina M, Haddock Luis J, Schwartz Stephen G, Lee Wen-Hsiang, Sridhar Jayanth, Wu David M, Flynn Harry W, Townsend Justin H

机构信息

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.

Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

出版信息

Ophthalmol Retina. 2021 Feb;5(2):178-183. doi: 10.1016/j.oret.2020.07.007. Epub 2020 Jul 14.

Abstract

PURPOSE

To describe the clinical features and outcomes in patients with rhegmatogenous retinal detachment (RRD) after intravitreal injection of pharmacologic agents.

DESIGN

Retrospecitve case series.

PARTICIPANTS

Patients diagnosed with rhegmatogenous retinal detachment within 3 months of receiving an intravitreal injection of a pharmacologic agent for treatment of macular disease.

METHODS

Retrospective case series of reported cases of RRD in patients with prior intravitreal injection who underwent subsequent surgical repair at a university referral center.

MAIN OUTCOME MEASURES

Visual acuity (VA), single surgery anatomic success rate (SSAS) and retinal reattachment at last follow-up.

RESULTS

Thirteen patients were identified to have RRD within 3 months of intravitreal injection. Injection was performed in the inferotemporal quadrant in 12 of 13 eyes (92%) with a 31- or 32-gauge needle. Additional risk factors for RRD other than intravitreal injection were present in 5 of 13 eyes (38%), including prior pars plana vitrectomy (3 eyes), history of retinal tear (1 eye), and history of RRD in the fellow eye (1 eye). Average duration from time of injection to diagnosis of RRD was 27 days (range, 5-43 days). Retinal reattachment was achieved in 12 of 13 eyes (92%). Visual acuity returned to baseline in only 3 of 13 eyes (23%) at the last follow-up visit.

CONCLUSIONS

Although RRD after intravitreal injection is rare, prior retinal surgery and alternate risk factors for RRD may predispose to RRD after intravitreal injection. Surgical outcomes were generally favorable, but VA outcomes were limited by the high rate of macula-off RRD and the underlying macular disease.

摘要

目的

描述玻璃体腔内注射药物制剂后发生孔源性视网膜脱离(RRD)患者的临床特征及预后。

设计

回顾性病例系列研究。

研究对象

在接受玻璃体腔内注射药物制剂治疗黄斑疾病后3个月内被诊断为孔源性视网膜脱离的患者。

方法

对一所大学转诊中心既往接受玻璃体腔内注射且随后接受手术修复的RRD患者的报告病例进行回顾性病例系列研究。

主要观察指标

视力(VA)、单次手术解剖成功率(SSAS)以及最后一次随访时的视网膜复位情况。

结果

13例患者在玻璃体腔内注射后3个月内发生RRD。13只眼中有12只眼(92%)在颞下象限进行了注射,使用的是31或32号针头。13只眼中有5只眼(38%)存在除玻璃体腔内注射外的RRD其他危险因素,包括既往玻璃体切割术(3只眼)、视网膜裂孔病史(1只眼)以及对侧眼RRD病史(1只眼)。从注射到诊断为RRD的平均时间为27天(范围5 - 43天)。13只眼中有12只眼(92%)实现了视网膜复位。在最后一次随访时,13只眼中只有3只眼(23%)的视力恢复到了基线水平。

结论

尽管玻璃体腔内注射后发生RRD很罕见,但既往视网膜手术及RRD的其他危险因素可能使患者在玻璃体腔内注射后易发生RRD。手术预后总体良好,但黄斑脱离RRD的高发生率及潜在的黄斑疾病限制了视力预后。

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