评价糖尿病性黄斑水肿行玻切加内界膜剥除术后的长期黄斑变化。

Evaluation of Macular Changes in the Long Term after Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Diabetic Macular Edema.

机构信息

Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.

Department of Ophthalmology, University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.

出版信息

Ophthalmologica. 2021;244(3):237-244. doi: 10.1159/000514992. Epub 2021 Feb 4.

DOI:10.1159/000514992

PMID:33540415

Abstract

AIM

To evaluate long-term macular changes following pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for diabetic macular edema (DME).

METHODS

Forty eligible eyes of 37 patients were included in this retrospective study. Best corrected visual acuity (BCVA), central macular thickness (CMT), and 5-mm macular volume (5-MV) were examined preoperatively, postoperatively after 1, 2, 3, 6, 12, and 24 months, and at a final visit. Response to surgical treatment was considered as recurrence, reincrease, or recovery of DME based on macular changes.

RESULTS

Mean follow-up time was 51.1 ± 19.0 months after surgery. Recurrence (n = 5) and reincrease (n = 17) of DME was observed in 22 eyes (55%) and additional treatments were applied. Recovery of DME was observed in 18 eyes (45%). Preoperative and final-visit mean BCVA (logMAR) was 1.08 ± 0.37 and 0.93 ± 0.45, respectively (p = 0.02). Preoperative and final-visit mean CMT was 514.74 ± 155.65 and 281.87 ± 112.58 µm, respectively (p < 0.001). The 5-MV significantly decreased following surgery (from 8.18 ± 1.57 to 6.52 ± 1.39 mm3; p < 0.001). DME was present in 12 eyes (30%) at the final visit.

CONCLUSION

Although PPV with ILM peeling had efficacy in DME management, this effect tended to decrease over time, such that a considerable number of patients required additional treatment.

摘要

目的

评估经平坦部玻璃体切除术（PPV）联合内界膜（ILM）剥除治疗糖尿病性黄斑水肿（DME）的长期黄斑变化。

方法

本回顾性研究纳入了 37 例 40 只眼符合条件的患者。在术前、术后 1、2、3、6、12 和 24 个月以及最终随访时检查最佳矫正视力（BCVA）、中心黄斑厚度（CMT）和 5mm 黄斑体积（5-MV）。根据黄斑变化，将手术治疗的反应定义为 DME 的复发、再加重或恢复。

结果

术后平均随访时间为 51.1±19.0 个月。22 只眼（55%）观察到 DME 的复发（n=5）和再加重（n=17），并进行了额外的治疗。18 只眼（45%）观察到 DME 的恢复。术前和最终随访时的平均 BCVA（logMAR）分别为 1.08±0.37 和 0.93±0.45（p=0.02）。术前和最终随访时的平均 CMT 分别为 514.74±155.65 和 281.87±112.58μm（p<0.001）。术后 5-MV 显著减少（从 8.18±1.57 降至 6.52±1.39mm3；p<0.001）。在最终随访时，12 只眼（30%）仍存在 DME。