Zhang Wenhua, Qiang Zeyuan, Song Hao, Li Xiaoli, Dan Handong, Ge Keke, Li Pan, Huang Zixu, Wang Dongdong, Chen Feng, Zheng Bin, Song Zongming
Henan University People's Hospital, Henan Provincial People's Hospital, Henan Eye Hospital, Zhengzhou 450003, Henan, China.
Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan Eye Hospital, Zhengzhou 450003, Henan, China.
J Ophthalmol. 2021 Apr 13;2021:6667755. doi: 10.1155/2021/6667755. eCollection 2021.
To evaluate the efficacy of pars plana vitrectomy (PPV) combined with episcleral cryotherapy in treating vasoproliferative tumors of the retina (VPTR) with macular complications.
In this retrospective noncomparative interventional case-series analysis, we included 11 eyes of ten patients diagnosed with VPTR. All patients underwent comprehensive ophthalmic examinations and were treated with PPV combined with episcleral cryotherapy. Best-corrected visual acuity (BCVA), tumor activity, retinal morphological structure, and postoperative complications were evaluated.
Macular complications included epimacular membrane ( = 10), macular hole ( = 3), and macular edema ( = 1). Tumors were treated with triple freeze-thaw episcleral cryotherapy during PPV. The mean logarithm of minimal angle of resolution (logMAR) BCVA dropped from 0.62 ± 0.58 to 0.39 ± 0.46. The difference between the mean values of logMAR BCVA before and after treatment was statistically significant ( = 2.48, =0.033). The tumor activity was controlled effectively in nine cases. Compared with preoperative tumor activity, tumor activity after treatment was significantly lower ( < 0.01). The increase of central retinal thickness and the disruption of retinal layers were associated with macular holes, macular edema, and retinal proliferative membrane. After the treatment, visual acuity improved in 91% of the cases, and 73% had no long-term complications.
PPV combined with episcleral cryotherapy promoted tumor regression, preserved retinal integrity, and improved visual acuity. Thus, the combination of PPV with episcleral cryotherapy can be considered effective and safe for the management of VPTR with macular complications.
评估玻璃体切割术（PPV）联合巩膜外冷冻疗法治疗伴有黄斑并发症的视网膜血管增生性肿瘤（VPTR）的疗效。
在这项回顾性非对照介入性病例系列分析中，我们纳入了10例诊断为VPTR的患者的11只眼。所有患者均接受了全面的眼科检查，并接受了PPV联合巩膜外冷冻疗法治疗。评估了最佳矫正视力（BCVA）、肿瘤活性、视网膜形态结构和术后并发症。
黄斑并发症包括黄斑前膜（n = 10）、黄斑裂孔（n = 3）和黄斑水肿（n = 1）。在PPV期间，采用三重冻融巩膜外冷冻疗法治疗肿瘤。平均最小分辨角对数（logMAR）BCVA从0.62±0.58降至0.39±0.46。治疗前后logMAR BCVA平均值之间的差异具有统计学意义（t = 2.48，P = 0.033）。9例患者的肿瘤活性得到有效控制。与术前肿瘤活性相比，治疗后肿瘤活性显著降低（P < 0.01）。视网膜中央厚度增加和视网膜层破坏与黄斑裂孔、黄斑水肿和视网膜增殖膜有关。治疗后，91%的患者视力提高，73%的患者无长期并发症。
PPV联合巩膜外冷冻疗法促进了肿瘤消退，保留了视网膜完整性，并提高了视力。因此，PPV与巩膜外冷冻疗法联合应用可被认为是治疗伴有黄斑并发症的VPTR的有效且安全的方法。
