Department of Ophthalmology, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy .
Retina. 2021 May 1;41(5):957-964. doi: 10.1097/IAE.0000000000003007.
To identify the incidence rate and the clinical characteristics of unexplained visual loss after gas tamponade for primary macula-sparing rhegmatogenous retinal detachment.
Retrospective longitudinal analysis of all subjects undergoing vitrectomy with gas for primary macula-on rhegmatogenous retinal detachment from 2010 to 2019. Outcome was the unexplained visual loss evaluated after gas absorption, defined as a loss of vision to less than 20/200 without evident causes. The diagnostic workup was reviewed.
Nine eyes with unexplained visual loss of 357 surgeries were found. The incidence proportion was 2.52 new cases every 1,000 eyes affected by macula-on rhegmatogenous retinal detachment treated with gas per year. All subjects had an absolute central scotoma, with a median postoperative visual acuity of 20/1,600 (counting fingers). Structural findings were consistent with an axonal damage; all eyes had microcystoid macular edema and reduced thickness of both macular ganglion cell and retinal nerve fiber layers. No photoreceptor structural damages were noted.
The incidence of unexplained visual loss after gas tamponade for primary macula-on rhegmatogenous retinal detachment is 2.52 new cases every 1,000 eyes per year. This rare complication, which findings are suggestive of an axonal damage within retinal ganglion cells, remains a serious and unexplained concern for vitreoretinal surgeons.
确定原发性黄斑区保留的孔源性视网膜脱离行气体填充后不明原因视力丧失的发生率和临床特征。
回顾性分析 2010 年至 2019 年间所有接受玻璃体切除联合气体填充治疗原发性黄斑区孔源性视网膜脱离的患者。主要结局为气体吸收后评估的不明原因视力丧失，定义为视力下降至低于 20/200 而无明显原因。对诊断检查进行了回顾。
在 357 例手术中发现 9 只眼存在不明原因的视力丧失。每年每 1000 只接受气体治疗的黄斑区孔源性视网膜脱离眼中有 2.52 例新发病例。所有患者均存在绝对中心暗点，术后视力中位数为 20/1600（手动）。结构发现与轴索损伤一致；所有眼均有微囊样黄斑水肿和黄斑神经节细胞及视网膜神经纤维层厚度均变薄。未观察到光感受器结构损伤。
原发性黄斑区保留的孔源性视网膜脱离行气体填充后不明原因视力丧失的发生率为每年每 1000 只眼中有 2.52 例新发病例。这种罕见的并发症，其发现提示视网膜神经节细胞内的轴索损伤，仍然是玻璃体视网膜外科医生面临的一个严重且不明原因的问题。
