Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland.
Eye (Lond). 2021 Oct;35(10):2834-2839. doi: 10.1038/s41433-020-01322-y. Epub 2020 Nov 30.
The purpose of this study is to investigate potential factors predicting complete recovery of visual acuity following surgery for macula off retinal detachment (RD).
Retrospective review of patients operated for macula-off RD at Jules-Gonin Eye Hospital between January 2015 and December 2016. The study included patients with visual acuity recovery of 0 LogMAR. A control group of 83 patients with comparable baseline characteristics but partial recovery of visual acuity after vitrectomy for macula-off RD was used for statistical comparison analysis.
Seventy-four patients, 46 males (62%) and 28 females (38%), were included. Mean age was 65 years (standard deviation: 12). Median follow-up was 6 months (interquartile range: 3). Fifty patients (68%) were pseudophakic. Median pre-op best-corrected visual acuity (BCVA) was 2 LogMAR (interquartile range: 1.22). Forty-three of the patients (58%) had preoperative BCVA equivalent of count fingers or less. The majority of the patients (91%) had up to 3-day duration of macular detachment (MD) before surgery. In comparison only 18% of the group of patients with partial recovery of visual acuity after vitrectomy for macula-off RD had been operated within 3 days of MD (p < 0.0001). In 63% of the 40 cases in whom an optical coherence tomography (OCT) of the fovea could be interpreted, OCT image showed a retained foveal depression of the detached retina, whereas only 35% of the 46 control eyes with adequate OCT imaging showed a retained foveal depression (p = 0.01).
In our study, patients had significantly better chances of complete visual acuity recovery when operated within 3 days of MD in comparison to more delayed surgery. Additionally, preservation of the foveal depression of the detached retina appeared to be a common characteristic among patients demonstrating complete visual recovery.
本研究旨在探讨预测视网膜脱离（RD）黄斑脱离手术后视力完全恢复的潜在因素。
回顾性分析 2015 年 1 月至 2016 年 12 月在 Jules-Gonin 眼科医院接受黄斑脱离 RD 手术的患者。研究包括视力恢复至 0 LogMAR 的患者。使用了 83 名具有可比基线特征但在黄斑脱离 RD 玻璃体切除术后部分恢复视力的对照组进行统计学比较分析。
74 名患者，46 名男性（62%）和 28 名女性（38%）入选。平均年龄为 65 岁（标准差：12）。中位随访时间为 6 个月（四分位距：3）。50 名患者（68%）为人工晶状体眼。术前最佳矫正视力（BCVA）中位数为 2 LogMAR（四分位距：1.22）。43 名患者（58%）术前 BCVA 相当于数指或以下。大多数患者（91%）在手术前有长达 3 天的黄斑脱离（MD）。相比之下，只有在黄斑脱离 RD 玻璃体切除术后视力部分恢复的患者中，只有 18%的患者在 MD 后 3 天内接受手术（p<0.0001）。在可以解释的 40 例中，63%的 OCT 图像显示脱离的视网膜存在保留的黄斑下凹陷，而仅有 46 例对照组中，35%的 OCT 图像显示保留的黄斑下凹陷（p=0.01）。
在我们的研究中，与更延迟的手术相比，患者在 MD 后 3 天内接受手术时，视力完全恢复的机会明显更高。此外，保留脱离的视网膜的黄斑下凹陷似乎是表现出完全视力恢复的患者的共同特征。
