Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan.
PLoS One. 2021 Oct 28;16(10):e0258775. doi: 10.1371/journal.pone.0258775. eCollection 2021.
To investigate clinical factors contributing to metamorphopsia after 27-gauge pars plana vitrectomy (27GPPV) for primary rhegmatogenous retinal detachment (RRD) to reveal whether the proximity of the preoperative retinal detachment to the fovea is associated with postoperative metamorphopsia.
We retrospectively reviewed medical records of 77 eyes of 77 patients after 27GPPV for RRD. Patients were subdivided into three groups using optical coherence tomography findings: Group A, patients with RRD outside the vascular arcade; Group B, patients whose condition was present within the vascular arcade, but without foveal detachment; and Group C, patients with foveal detachment.
The average metamorphopsia score (°) assessed with M-charts 12 months after surgery was 0.01 ± 0.04 in Group A (24 eyes), 0.08 ± 0.18 in Group B (20 eyes), and 0.49 ± 0.48 in Group C (33 eyes) (p<0.001). Logistic regression analysis revealed that metamorphopsia at 12 months after surgery significantly correlated with the proximity of the retinal detachment to the fovea (p = 0.007).
Metamorphopsia after 27GPPV for RRD correlated with the proximity of the preoperative retinal detachment to the fovea. Attention should be paid to the possibility of postoperative metamorphopsia development when retinal detachment is present within a vascular arcade even if the fovea is not involved.
研究 27G 巩膜外环扎式玻璃体切除术（27GPPV）治疗原发性孔源性视网膜脱离（RRD）后导致的视物变形的临床因素，以揭示术前视网膜脱离与术后视物变形之间的关系。
我们回顾性分析了 77 例 77 只眼接受 27GPPV 治疗 RRD 患者的病历资料。根据光学相干断层扫描（OCT）结果，患者被分为三组：A 组，视网膜脱离位于血管弓以外；B 组，视网膜脱离位于血管弓内，但未累及黄斑；C 组，视网膜脱离累及黄斑。
术后 12 个月，M-chart 评估的平均视物变形评分（°）在 A 组（24 只眼）为 0.01 ± 0.04，B 组（20 只眼）为 0.08 ± 0.18，C 组（33 只眼）为 0.49 ± 0.48（p<0.001）。Logistic 回归分析显示，术后 12 个月的视物变形与视网膜脱离与黄斑的接近程度显著相关（p=0.007）。
27GPPV 治疗 RRD 后的视物变形与术前视网膜脱离与黄斑的接近程度有关。即使黄斑未受累，当视网膜脱离位于血管弓内时，也应注意术后发生视物变形的可能性。
