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玻璃体切割治疗黄斑裂孔性视网膜脱离术后长期视功能预后的预测因素。

Predictive Factors for Long-Term Postoperative Visual Outcome in Patients with Macula-Off Rhegmatogenous Retinal Detachment Treated with Vitrectomy.

机构信息

2nd Department of Ophthalmology, University of Athens, Athens, Greece.

2nd Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece.

出版信息

Ophthalmologica. 2021;244(3):213-217. doi: 10.1159/000514538. Epub 2021 Jan 19.

Abstract

PURPOSE

The purpose of this prospective study was to evaluate potential predictive factors of long-term postoperative outcomes in patients with macula-off rhegmatogenous retinal detachment (RRD) treated with pars plana vitrectomy (PPV).

METHODS

Participants in this study were 86 patients diagnosed with macula-off RRD, who underwent PPV. Demographic characteristics and preoperative characteristics of RRD were recorded, while best corrected visual acuity (BCVA) was measured preoperatively and at specific postoperative time points (6 weeks and 6, 12, and 24 months). In addition, spectral domain-optical coherence tomography (SD-OCT) characteristics at postoperative week 6 were assessed as potential factors affecting the long-term postoperative visual outcome 24 months after PPV for RRD.

RESULTS

Increasing age, duration of RD of more than 1 week, presence of proliferative vitreoretinopathy, increasing central retinal thickness, ellipsoid zone disruption, and external limiting membrane disruption were significantly associated with a worse BVCA. BCVA was not associated with gender, lens status, the location of breaks, the gas tamponade agent used in PPV, the presence of subretinal fluid, and intraretinal fluid.

CONCLUSIONS

It is important to determine predictive factors for visual outcomes in order to inform patients about their prognosis and help in the decision-making process for patient management.

摘要

目的

本前瞻性研究旨在评估接受玻璃体切除术(PPV)治疗的黄斑脱离裂孔性视网膜脱离(RRD)患者长期术后结局的潜在预测因素。

方法

本研究纳入 86 例黄斑脱离 RRD 患者,所有患者均接受了 PPV。记录了患者的人口统计学特征和 RRD 的术前特征,同时在术前和特定术后时间点(6 周以及 6、12 和 24 个月)测量最佳矫正视力(BCVA)。此外,还评估了术后 6 周的频域光相干断层扫描(SD-OCT)特征,以评估这些特征是否为影响 RRD 患者接受 PPV 后 24 个月长期术后视力的潜在因素。

结果

年龄增长、RD 持续时间超过 1 周、存在增殖性玻璃体视网膜病变、中央视网膜厚度增加、椭圆体带破坏以及外界膜破坏与更差的 BCVA 显著相关。BCVA 与性别、晶状体状态、裂孔位置、PPV 中使用的气体填充剂、视网膜下液的存在以及视网膜内液无关。

结论

确定视力结果的预测因素对于告知患者预后并帮助决策患者管理非常重要。

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