Yamada Hiroko, Imai Hisanori, Tetsumoto Akira, Hayashida Mayuka, Otsuka Keiko, Miki Akiko, Kusuhara Sentaro, Nakamura Makoto
Division of Ophthalmology, Department of Surgery-Related, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Kobe Kaisei Hospital, 3-11-15 Shinohara Kitamachi, Nada-ku, Kobe, 657-0068, Japan.
Sci Rep. 2021 Apr 19;11(1):8460. doi: 10.1038/s41598-021-88149-z.
To demonstrate the long-term effect of cystotomy with or without fibrinogen clot removal for treatment-resistant cystoid macular edema (CME) secondary to branch retinal vein occlusion (BRVO). Retrospective clinical study. We retrospectively analyzed medical records of 22 eyes of 22 patients with treatment-resistant CME secondary to BRVO with 12 months observation after cystotomy with or without fibrinogen clot removal. Patients included 11 women and 11 men. The mean ± SD age was 72.7 ± 10.2 years. LogMAR-converted best corrected visual acuity (BCVA) was statistically better at 12 months after surgery (0.30 ± 0.30) than preoperative BCVA (0.39 ± 0.27) (p = 0.01). The central sensitivity of microperimetry (dB) was maintained during follow-up (preoperative sensitivity: 25.4 ± 4.1, postoperative sensitivity at 12 months after the surgery: 25.9 ± 4.2, p = 0.69). Twelve months after surgery, there was a significant improvement in the central retinal thickness (CRT) on optical coherence tomography (OCT) (303.7 ± 80.1) (μm) compared with the preoperative CRT (524.2 ± 114.8) (p < 0.01). In 12 months, CME recurred in 3 of 22 eyes. The preoperative reflectivity in cystoid cavity on OCT was significantly higher in patients with fibrinogen clot removal (n = 5) than in patients without fibrinogen clot removal (n = 17) (p < 0.01). For treatment-resistant CME secondary to BRVO, Cystotomy with or without fibrinogen clot removal may be one of the treatment options.
为证明行或不行纤维蛋白原凝块清除术的膀胱切开术治疗视网膜分支静脉阻塞（BRVO）继发的难治性黄斑囊样水肿（CME）的长期效果。回顾性临床研究。我们回顾性分析了22例BRVO继发难治性CME患者的22只眼的病历，在膀胱切开术（行或不行纤维蛋白原凝块清除术）后进行了12个月的观察。患者包括11名女性和11名男性。平均年龄±标准差为72.7±10.2岁。LogMAR转换后的最佳矫正视力（BCVA）在术后12个月（0.30±0.30）比术前BCVA（0.39±0.27）有统计学意义的改善（p = 0.01）。微视野检查的中心敏感度（dB）在随访期间保持稳定（术前敏感度：25.4±4.1，术后12个月敏感度：25.9±4.2，p = 0.69）。术后12个月，光学相干断层扫描（OCT）显示中心视网膜厚度（CRT）较术前有显著改善（303.7±80.1）（μm），术前CRT为（524.2±114.8）（p < 0.01）。22只眼中有3只在12个月时CME复发。行纤维蛋白原凝块清除术的患者（n = 5）术前OCT上囊样腔内的反射率显著高于未行纤维蛋白原凝块清除术的患者（n = 17）（p < 0.01）。对于BRVO继发的难治性CME，行或不行纤维蛋白原凝块清除术的膀胱切开术可能是治疗选择之一。
