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术后黄斑增殖性玻璃体视网膜病变:病例系列及文献综述

Postoperative Macular Proliferative Vitreoretinopathy: A Case Series and Literature Review.

作者信息

Khateb Samer, Aweidah Hamzah, Halpert Michael, Jaouni Tareq

机构信息

Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

出版信息

Case Rep Ophthalmol. 2021 May 27;12(2):464-472. doi: 10.1159/000512285. eCollection 2021 May-Aug.

Abstract

Premacular membranes developing following pars plana vitrectomy (PPV) can cause significant anatomical and functional deficits to the macula. Recent reports showed that postoperative premacular membranes are a localized presentation of macular proliferative vitreoretinopathy (mPVR). Here, we report retrospectively a case series of 5 patients with severe mPVR which developed following uneventful PPV and were followed up to 32 months in the Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, between October 2016 and February 2020. All patients underwent primary repair of rhegmatogenous retinal detachment (RRD) before mPVR developed. Mean best-corrected visual acuity (BCVA) at presentation was 20/76 Snellen (0.58 LogMAR). Median duration of the retinal detachment time until surgery was 1.5 days (range 1-21 days). Mean interval time from last normal follow-up exam to diagnosis of mPVR was 19 days (range 10-28). BCVA dropped from a mean of 20/38 Snellen (0.28 LogMAR) prior to mPVR development to 20/166 Snellen (0.92 LogMAR) following its development, recovering to 20/57 Snellen (0.45 LogMAR) after peeling of membranes. Mean central macular thickness measured by optical coherence tomography decreased from 711 to 354 μm postsurgery. In conclusion, short-term mPVR is a different entity from macular pucker in terms of rapid development, structural distortion, and visual compromise. Surgical treatment significantly restores macular function and anatomy.

摘要

玻璃体切除术后形成的黄斑前膜可导致黄斑显著的解剖和功能缺陷。最近的报告显示,术后黄斑前膜是黄斑增殖性玻璃体视网膜病变(mPVR)的一种局部表现。在此,我们回顾性报告了一组5例严重mPVR患者的病例系列,这些患者在2016年10月至2020年2月期间于耶路撒冷哈达萨希伯来大学医学中心眼科接受了顺利的玻璃体切除术后发生mPVR,并随访了32个月。所有患者在mPVR发生前均接受了孔源性视网膜脱离(RRD)的一期修复。就诊时的平均最佳矫正视力(BCVA)为20/76 Snellen(0.58 LogMAR)。视网膜脱离至手术的中位时间为1.5天(范围1 - 21天)。从最后一次正常随访检查到mPVR诊断的平均间隔时间为19天(范围10 - 28天)。BCVA从mPVR发生前的平均20/38 Snellen(0.28 LogMAR)下降至发生后的20/166 Snellen(0.92 LogMAR),在膜剥除后恢复至20/57 Snellen(0.45 LogMAR)。光学相干断层扫描测量的平均黄斑中心厚度术后从711μm降至354μm。总之,短期mPVR在快速发展、结构变形和视力损害方面与黄斑皱襞是不同的实体。手术治疗可显著恢复黄斑功能和解剖结构。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b31/8215993/001ae60b653d/cop-0012-0464-g01.jpg

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