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人羊膜移植治疗糖尿病牵拉性视网膜脱离及合并牵拉性和孔源性视网膜脱离的视网膜裂孔。

Human amniotic membrane grafts for retinal breaks in diabetic tractional retinal detachment and combined tractional and rhegmatogenous retinal detachment.

机构信息

Department of Ophthalmology, Changhua Christian Hospital, No. 135, Nanxiao Street, Changhua City, Taiwan.

Department of Ophthalmology, Yunlin Christian Hospital, Xiluo, Taiwan.

出版信息

Sci Rep. 2021 Apr 13;11(1):8035. doi: 10.1038/s41598-021-86804-z.

Abstract

To describe the surgical outcomes of using human amniotic membrane (hAM) grafts in the management of retinal breaks in diabetic tractional detachment (TRD) and combined tractional and rhegmatogenous retinal detachment (CTRRD). A retrospective case series of 10 eyes with TRD or CTRRD receiving pars plana vitrectomy with hAM grafts implantation, compared with 13 controls receiving the same surgery without hAM grafts. Best-corrected visual acuity (BCVA) and re-detachment rate were compared between two groups. Postoperatively, all eyes in the hAM group had retina attachment without recurrence, while 9 eyes in the control group had retina re-detachment and required additional surgery (0% vs 69.2%, p = 0.003). The BCVA significantly improved in the hAM group (from 1.96 ± 0.95 to 1.44 ± 0.77 in log MAR, p = 0.03), but not improved in control group (p = 0.20). Postoperative optical coherence tomography of the eyes receiving hAM grafts demonstrated glial tissue regeneration and restoration of ellipsoid zone. In diabetic TRD or CTRRD, hAM grafts could be an effective method, with promising outcome. Compared to standard surgery, it could result in higher retina reattachment rate and significant visual improvement. Moreover, it may offer the adjunctive benefit in tissue regeneration and fasten ellipsoid zone restoration.

摘要

描述在糖尿病牵引性脱离(TRD)和合并牵引性和孔源性视网膜脱离(CTRRD)中使用人羊膜(hAM)移植物治疗视网膜裂孔的手术结果。对 10 只接受巩膜外玻璃体切除术联合 hAM 移植物植入术治疗 TRD 或 CTRRD 的患者进行回顾性病例系列研究,并与 13 名接受相同手术但未接受 hAM 移植物的对照组患者进行比较。比较两组的最佳矫正视力(BCVA)和再脱离率。术后 hAM 组所有眼均无视网膜再脱离,而对照组 9 眼发生视网膜再脱离,需要再次手术(0%比 69.2%,p=0.003)。hAM 组 BCVA 显著改善(从 logMAR 的 1.96±0.95 提高至 1.44±0.77,p=0.03),而对照组无改善(p=0.20)。接受 hAM 移植物的眼的术后光学相干断层扫描显示神经胶质组织再生和椭圆体带恢复。在糖尿病性 TRD 或 CTRRD 中,hAM 移植物可能是一种有效的方法,具有良好的效果。与标准手术相比,它可能导致更高的视网膜再附着率和显著的视力改善。此外,它可能在组织再生方面提供附加益处,并加速椭圆体带的恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2391/8044097/acf16a6a4b46/41598_2021_86804_Fig1_HTML.jpg

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