Chihara Etsuo, Chihara Tomoyuki, Matsuzaki Shoko
Department of Ophthalmology, Sensho-kai Eye Institute, Kyoto, Japan.
Department of Ophthalmology, Shimane University, Matsue, Japan.
Retina. 2021 Dec 1;41(12):2571-2577. doi: 10.1097/IAE.0000000000003216.
To examine hypotony-associated foveal lesions (FovLs) using optical coherence tomography, and to assess the risk factors of visual deterioration after glaucoma filtering surgery.
Parameters that may be associated with postsurgical deterioration of visual acuity were retrospectively studied in 44 eyes of 44 patients who experienced postsurgical intraocular hypotension ≤6 mmHg between 2015 and 2019.
Six eyes (14%) had FovLs, such as detachment of photoreceptors (5 eyes, 11%) and acquired vitelliform lesions (1 eye, 2%) at 3 months after trabeculectomy. Logistic regression analysis revealed that hypotony maculopathy (P = 0.0141 at 3 months) and FovLs (P = 0.0486 and 0.0296 at 3 and 12 months, respectively) were significant risk factors for Visual acuity loss after trabeculectomy. The FovLs were located just behind the Müller cell cone. Visual acuity at 3 and 12 months after surgery in patients with FovLs was significantly lower than in those without FovLs (P = 0.0013 and P = 0.006, respectively). Epiretinal membrane was more common in eyes with FovLs (5 of 6 eyes, 83%) than in eyes without FovLs (7 of 38 eyes, 18%; P = 0.0037).
Müller cell cone-associated FovLs lead to long-lasting visual acuity loss after filtering surgery.
使用光学相干断层扫描检查低眼压相关性黄斑病变（FovLs），并评估青光眼滤过术后视力下降的危险因素。
回顾性研究2015年至2019年间44例术后眼压≤6 mmHg的患者的44只眼中可能与术后视力下降相关的参数。
6只眼（14%）在小梁切除术后3个月出现FovLs，如光感受器脱离（5只眼，11%）和获得性卵黄样病变（1只眼，2%）。逻辑回归分析显示，低眼压性黄斑病变（3个月时P = 0.0141）和FovLs（3个月和12个月时分别为P = 0.0486和0.0296）是小梁切除术后视力丧失的重要危险因素。FovLs位于Müller细胞锥体后方。有FovLs的患者术后3个月和12个月的视力显著低于无FovLs的患者（分别为P = 0.0013和P = 0.006）。视网膜前膜在有FovLs的眼中（6只眼中的5只，83%）比在无FovLs的眼中（38只眼中的7只，18%）更常见（P = 0.0037）。
与Müller细胞锥体相关的FovLs导致滤过术后长期视力丧失。
