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[增殖性玻璃体视网膜病变(PVR)轻度:相同却又不同。PVR相关性黄斑皱襞的特征及手术治疗]

[Proliferative vitreoretinopathy (PVR) minimal: same, same but different. Characteristics and surgical treatment of PVR-associated macular pucker].

作者信息

Hattenbach L-O, Grisanti S, Priglinger S G, Chronopoulos A

机构信息

Augenklinik des Klinikums Ludwigshafen, Bremserstr. 79, 67063, Ludwigshafen, Deutschland.

Augenklinik, der Universitätsmedizin Lübeck, Lübeck, Deutschland.

出版信息

Ophthalmologe. 2021 Jan;118(1):24-29. doi: 10.1007/s00347-020-01292-2.

Abstract

BACKGROUND

Epiretinal membrane formation resulting in a macular pucker is among the typical complications associated with proliferative vitreoretinopathy (PVR) in retinal detachment and has a major impact on the functional outcome after surgical treatment.

METHODS

A literature search was carried out in PubMed.

RESULTS

Approaches to the surgical treatment of PVR-associated macular pucker include complete membrane removal within the vascular arcades aimed at relieving retinal traction at the posterior pole and peeling of the internal limiting membrane (ILM). As a further option it has been suggested that primary ILM peeling in rhegmatogenous retinal detachment repair may reduce or even prevent postoperative epiretinal membrane formation. In addition, correct timing of surgery is a factor that may contribute to successful treatment.

DISCUSSION

Due to the particularly strong adhesion and the frequent occurrence of concurrent retinal detachment, the surgical approach to PVR-associated macular pucker is particularly challenging. As with idiopathic epiretinal membranes, surgical removal has the potential to improve functional outcomes; however, visual improvement depends largely on whether the macula was involved in the original retinal detachment.

摘要

背景

导致黄斑皱襞的视网膜前膜形成是视网膜脱离中增殖性玻璃体视网膜病变(PVR)相关的典型并发症之一,对手术治疗后的功能预后有重大影响。

方法

在PubMed上进行文献检索。

结果

PVR相关黄斑皱襞的手术治疗方法包括在血管弓内完全去除膜以缓解后极部视网膜牵引以及剥除内界膜(ILM)。作为另一种选择,有人提出在孔源性视网膜脱离修复术中早期剥除ILM可能会减少甚至预防术后视网膜前膜形成。此外,正确的手术时机是有助于成功治疗的一个因素。

讨论

由于其特别强的粘连性以及并发视网膜脱离的频繁发生,PVR相关黄斑皱襞的手术方法极具挑战性。与特发性视网膜前膜一样,手术切除有可能改善功能预后;然而,视力改善很大程度上取决于黄斑是否参与了原始视网膜脱离。

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