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眼内注射后发生的孔源性视网膜脱离的特征和手术结果。

Characteristics and surgical outcomes of rhegmatogenous retinal detachments that develop after intravitreal injections.

机构信息

Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-0856, Japan.

出版信息

Jpn J Ophthalmol. 2021 Jul;65(4):492-496. doi: 10.1007/s10384-021-00834-8. Epub 2021 Mar 21.

Abstract

PURPOSE

To determine the frequency and characteristics of rhegmatogenous retinal detachments (RRDs) that develop after an intravitreal injection of anti-vascular endothelial growth factor (VEGF) agent.

STUDY DESIGN

A retrospective review of the medical charts.

METHODS

The charts of patients who received intravitreal injections for age-related macular degeneration (AMD), diabetic macular edema (DME), retinal vein occlusion (RVO), or myopic choroidal neovascularization (mCNV) between 2013 and 2020 were reviewed. We included the RRD cases that developed within 90 days of the most recent intravitreal injection. The baseline characteristics and surgical outcomes were analyzed.

RESULTS

A total of 3040 patients received 28,190 intravitreal injections. Seven eyes of 7 cases developed a RRD. There were 6 cases of AMD and one of DME, with an incidence of one in 4027 injections (0.025%). The retinal break was in the superior quadrants in 5 eyes (71%), and in the inferior quadrants in 2 eyes. All eyes had a posterior vitreous detachment. The average number of injections before the development of RRD was 14.1 (range: 2-39). Four eyes were treated by vitrectomy, and 3 by scleral buckling. The primary success rate was 86%, and the final reattachment rate was 100%. The best-corrected visual acuity was 0.41 ± 0.26 logarithm of minimal angle of resolution (logMAR) units before developing the RRD, 0.78 ± 0.78 logMAR units before the surgery for RRD, and 0.45 ± 0.47 logMAR units at the final visit.

CONCLUSIONS

The incidence of RRD after an intravitreal injection is very low (0.025%), and it can be reattached with recovery of the visual acuity.

摘要

目的

确定玻璃体内注射抗血管内皮生长因子(VEGF)药物后发生孔源性视网膜脱离(RRD)的频率和特征。

研究设计

回顾性病历审查。

方法

对 2013 年至 2020 年间接受玻璃体内注射治疗年龄相关性黄斑变性(AMD)、糖尿病性黄斑水肿(DME)、视网膜静脉阻塞(RVO)或近视性脉络膜新生血管(mCNV)的患者的图表进行了回顾。我们纳入了在最近一次玻璃体内注射后 90 天内发生的 RRD 病例。分析了基线特征和手术结果。

结果

共有 3040 名患者接受了 28190 次玻璃体内注射。7 例 7 只眼发生 RRD。其中 6 例为 AMD,1 例为 DME,发病率为每 4027 次注射 1 例(0.025%)。5 只眼的视网膜裂孔位于上象限(71%),2 只眼位于下象限。所有眼均有后玻璃体脱离。发生 RRD 前的平均注射次数为 14.1 次(范围:2-39 次)。4 只眼行玻璃体切除术,3 只眼行巩膜扣带术。初次手术成功率为 86%,最终再附着率为 100%。发生 RRD 前最佳矫正视力为 0.41±0.26 最小角分辨对数视力(logMAR)单位,RRD 手术前为 0.78±0.78 logMAR 单位,最终随访时为 0.45±0.47 logMAR 单位。

结论

玻璃体内注射后 RRD 的发生率非常低(0.025%),且可通过视力恢复进行再附着。

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