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板层黄斑裂孔和视网膜内界膜黄斑瓣裂孔的玻璃体切割术后视力结果和预后因素。

Visual outcomes and prognostic factors of vitrectomy for lamellar macular holes and epiretinal membrane foveoschisis.

机构信息

Department of Ophthalmology, The University of Tokyo, Tokyo, Japan.

Department of Ophthalmology and Micro-Technology, Yokohama City University, Kanagawa, Japan.

出版信息

PLoS One. 2021 Feb 22;16(2):e0247509. doi: 10.1371/journal.pone.0247509. eCollection 2021.

Abstract

PURPOSE

To evaluate the visual outcomes of vitrectomy for lamellar macular hole (LMH) and epiretinal membrane (ERM) foveoschisis and to investigate the prognostic factor for postoperative visual acuity.

METHODS

We retrospectively reviewed 15 LMH and 17 ERM foveoschisis eyes that had undergone a standard three-port pars plana vitrectomy with (12 eyes) or without (20 eyes) cataract surgery. Best-corrected visual acuity (BCVA) at postoperative three months and the final visit were compared to the preoperative measurements. We investigated the relationship between BCVA at the final visit and baseline parameters (age, preoperative BCVA, the presence of epiretinal proliferation [EP] and ellipsoid zone [EZ] disruption). The best explanatory variables for the final BCVA were investigated using the corrected Akaike information criterion (AICc) model selection.

RESULTS

The mean age was 67.2 years. The mean follow-up duration was 30.7 months. Fifteen of 32 examined eyes were diagnosed as LMH and 17 eyes as ERM foveoschisis. Twelve eyes in LMH had EP and 13 eyes showed the disruption of EZ integrity. In total, BCVA significantly improved at 3 months postoperatively (p = 0.0013). A significant improvement was observed in ERM foveoschisis (p = 0.0085) but not in LMH group (p = 0.071). Comparing the BCVA between the baseline and the final visit, significant improvements were observed in total, ERM foveoschisis and LMH group (p<0.001, p<0.001 and p = 0.026, respectively). The optimal model for BCVA at the final visit included preoperative BCVA and the presence of EZ disruption (p<0.001 and p<0.001, respectively).

CONCLUSION

Our results suggested that the final BCVA was dependent on preoperative BCVA and the presence of EZ disruption. Surgical indications might be warranted for LMHs with EZ disruption.

摘要

目的

评估板层黄斑裂孔(LMH)和视网膜内膜(ERM)黄斑劈裂的玻璃体切除术的视觉效果,并探讨术后视力的预测因素。

方法

我们回顾性分析了 15 例 LMH 和 17 例 ERM 黄斑劈裂接受标准三通道经睫状体平坦部玻璃体切除术的患者(12 例接受白内障手术,20 例未接受白内障手术)。将术后 3 个月和最终随访时的最佳矫正视力(BCVA)与术前测量值进行比较。我们研究了最终 BCVA 与基线参数(年龄、术前 BCVA、是否存在视网膜内增殖[EP]和椭圆体带[EZ]破坏)之间的关系。使用校正赤池信息量准则(AICc)模型选择来研究最终 BCVA 的最佳解释变量。

结果

平均年龄为 67.2 岁。平均随访时间为 30.7 个月。在 32 只检查的眼中,15 只被诊断为 LMH,17 只被诊断为 ERM 黄斑劈裂。在 LMH 中,12 只眼有 EP,13 只眼显示 EZ 完整性中断。总的来说,术后 3 个月 BCVA 显著提高(p = 0.0013)。在 ERM 黄斑劈裂中观察到显著改善(p = 0.0085),但在 LMH 组中未观察到(p = 0.071)。比较基线和最终随访时的 BCVA,总视力、ERM 黄斑劈裂和 LMH 组均有显著改善(p<0.001,p<0.001 和 p = 0.026,分别)。最终 BCVA 的最佳模型包括术前 BCVA 和 EZ 破坏的存在(p<0.001 和 p<0.001,分别)。

结论

我们的结果表明,最终 BCVA 取决于术前 BCVA 和 EZ 破坏的存在。对于有 EZ 破坏的 LMH,可能需要手术适应证。

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