Department of Ophthalmology & Vision Sciences, The John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
Eye (Lond). 2021 Dec;35(12):3285-3291. doi: 10.1038/s41433-021-01399-z. Epub 2021 Jan 29.
To evaluate the correlation between foveal changes in the detached retina in macula-off rhegmatogenous retinal detachments (RRD) and visual acuity outcome following repair.
Retrospective, consecutive, observational case series.
Consecutive patients presenting with macula-off RRD between July 15 and September 15, 2017, underwent SD-OCT imaging and their medical records were reviewed. Specific OCT exam parameters were used to evaluate the fovea of the detached retina.
In total, 47 patients with macula-off RRD were treated from July 15 to September 15, 2017. Forty-four eyes of 44 patients could be imaged by SD-OCT and were included in the analysis. Univariate analysis demonstrated a correlation between the height of the detachment, the duration of symptoms, the presence of macular hole and epiretinal membrane to the final VA. Correlation was also found between the presence of MH and the height of the detachment. However, multiple regression analysis demonstrated only a statistically significant correlation between the presence of a macular hole or an epiretinal membrane to the final VA.
Our study is the first to demonstrate the significance of foveal changes in the pathogenesis of lost vision in macula-off retinal detachments. The high rate of macular holes and the correlation between the MH and the height of the detachment suggest that elevated tension in the fovea in high detachments might play a significant role in the visual outcome of macula-off RRD following repair.
评估孔源性视网膜脱离（RRD）黄斑脱离后脱离视网膜黄斑区变化与视力恢复结果之间的相关性。
回顾性、连续、观察性病例系列研究。
2017 年 7 月 15 日至 9 月 15 日连续就诊的黄斑脱离 RRD 患者接受了 SD-OCT 成像，回顾了他们的病历。使用特定的 OCT 检查参数评估脱离视网膜的黄斑。
共有 47 例黄斑脱离 RRD 患者于 2017 年 7 月 15 日至 9 月 15 日接受治疗。44 例患者的 44 只眼可进行 SD-OCT 成像并纳入分析。单因素分析表明，脱离高度、症状持续时间、黄斑裂孔和视网膜前膜的存在与最终 VA 之间存在相关性。还发现 MH 的存在与脱离的高度之间存在相关性。然而，多元回归分析仅显示黄斑裂孔或视网膜前膜的存在与最终 VA 之间存在统计学显著相关性。
我们的研究首次证明了黄斑脱离中黄斑区变化在视力丧失发病机制中的重要性。黄斑孔的高发生率以及 MH 与脱离高度之间的相关性表明，高脱离时黄斑下张力升高可能在黄斑脱离 RRD 修复后的视力结果中发挥重要作用。
