Oli Avadhesh, Balakrishnan Divya
Smt Kanuri Santhamma Centre of Vitreoretinal diseases, LV Prasad Eye Institute, Kallam Anji Reddy Campus, L. V. Prasad Marg, Banjara Hills, Hyderabad 500034, Telangana, India.
Smt Kanuri Santhamma Centre of Vitreoretinal diseases, LV Prasad Eye Institute, Hyderabad, India.
Ther Adv Ophthalmol. 2021 Jun 30;13:25158414211027715. doi: 10.1177/25158414211027715. eCollection 2021 Jan-Dec.
To study the long-term outcomes of optic disc pit maculopathy.
Electronic medical records of 154 patients with optic disc pit were reviewed and 50 patients with optic disc pit maculopathy who met the study criteria were included in the study. Demographic profile of patients, along with clinical characteristics, optical coherence tomography (OCT) features and change in best-corrected visual acuity (BCVA) was recorded. Patients were treated either by observation, barrage laser alone or pars plana vitrectomy (PPV) with optional additional surgical procedures. The primary outcome measures were the change in BCVA and resolution of fluid on OCT.
The mean age of patients was 29.96 years (3-62 years) with a follow-up of 27.16 months. The mean baseline BCVA in observation, laser and vitrectomy group was log MAR 0.94, 0.76 and 0.87 and final BCVA was log MAR 0.9, 0.67 and 0.46, respectively. There was a statistically significant improvement in the final BCVA and reduction in subretinal fluid with resolution of the schisis cavity in vitrectomy group than in other groups. On regression analysis significant association was found between final BCVA with baseline BCVA ( = 0.815, = 0.002), use of C3 F8 endotempanode ( = 0.004) ILM peeling ( = 0.012) and use of triamcinolone (TA; = 0.003). No significant association was found with juxtapapillary endolaser ( = 0.062).
In patients with disc pit maculopathy, PPV lead to better functional and anatomical outcomes as compared to laser or observation alone. Use of surgical adjuvants like ILM peeling, TA and C3F8 tamponade improved the outcomes, unlike juxtapapillary endolaser treatment.
研究视盘小凹黄斑病变的长期预后。
回顾154例视盘小凹患者的电子病历,纳入50例符合研究标准的视盘小凹黄斑病变患者。记录患者的人口统计学资料、临床特征、光学相干断层扫描(OCT)特征及最佳矫正视力(BCVA)变化。患者接受观察、单纯格栅样光凝或玻璃体切除术(PPV)及可选的附加手术治疗。主要观察指标为BCVA变化及OCT上积液的消退情况。
患者平均年龄29.96岁(3 - 62岁),随访27.16个月。观察、光凝和玻璃体切除组的平均基线BCVA分别为log MAR 0.94、0.76和0.87,最终BCVA分别为log MAR 0.9、0.67和0.46。与其他组相比,玻璃体切除组最终BCVA有统计学显著改善,视网膜下液减少,视网膜劈裂腔消退。回归分析发现最终BCVA与基线BCVA( = 0.815, = 0.002)、使用C3 F8内界膜填塞物( = 0.004)、内界膜剥除( = 0.012)及使用曲安奈德(TA; = 0.003)之间存在显著相关性。未发现与视乳头旁视网膜内激光光凝有显著相关性( = 0.062)。
对于视盘小凹黄斑病变患者,与单纯激光治疗或观察相比,PPV可带来更好的功能和解剖学预后。使用内界膜剥除、TA和C3F8填塞等手术辅助手段可改善预后,与视乳头旁视网膜内激光光凝治疗不同。