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初眼行玻璃体切除术治疗后对侧眼近视牵引性黄斑病变的进展模式。

Progression Patterns of Myopic Traction Maculopathy in the Fellow Eye After Pars Plana Vitrectomy of the Primary Eye.

机构信息

Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China.

Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality, Shanghai, China.

出版信息

Invest Ophthalmol Vis Sci. 2021 Dec 1;62(15):9. doi: 10.1167/iovs.62.15.9.

Abstract

PURPOSE

This retrospective study investigated the patterns and risk factors of progression of myopic traction maculopathy (MTM) of fellow eyes after pars plana vitrectomy (PPV) of primary eyes.

METHODS

The study population comprised 153 patients with MTM in both myopic eyes who sequentially underwent PPV (2006-2021). Observation periods were from PPV of the primary eye (baseline) to PPV of the fellow (end). MTM was graded based on optical coherence tomography (OCT) images and the ATN (atrophy [A], traction [T], and neovascularization [N]) system. An increase in T grade was considered MTM progression.

RESULTS

MTM progressed in 43.8% of fellow eyes during 34.57 ± 34.08 months. The progression of fellow eyes correlated with T grade of primary eyes (P < 0.001). Risk factors for the progression of MTM in fellow eyes were primary eyes in T4-T5, age at baseline <60 years, and fellow eyes with partial posterior vitreous detachment (PVD; P < 0.001, P = 0.042, and P = 0.002, respectively). Fellow eyes in T1/T2 at baseline progressed faster compared with those in T0 (P < 0.001); the annual rate of progression to T3-T5 of the T0 (T1-T2) groups was 9.98% (24.59%).

CONCLUSIONS

Risk factors for the progression of MTM in fellow eyes included PPV when relatively young, primary eye at high T grade, and partial PVD of the fellow eye. Personalized follow-up for fellow eyes should be based on the severity of MTM of both eyes.

摘要

目的

本回顾性研究调查了原发性眼行玻璃体切除术(PPV)后,对侧眼近视牵引性黄斑病变(MTM)进展的模式和危险因素。

方法

研究人群包括 153 例双眼近视伴 MTM 的患者,他们先后接受了 PPV(2006-2021 年)。观察期从原发性眼的 PPV(基线)到对侧眼的 PPV(终点)。MTM 根据光学相干断层扫描(OCT)图像和 ATN(萎缩[A]、牵引[T]和新生血管[N])系统进行分级。T 级增加被认为是 MTM 进展。

结果

在 34.57±34.08 个月期间,对侧眼的 MTM 进展了 43.8%。对侧眼的进展与原发性眼的 T 级相关(P<0.001)。对侧眼 MTM 进展的危险因素是原发性眼在 T4-T5,基线时年龄<60 岁,以及对侧眼有部分后玻璃体脱离(PVD;P<0.001、P=0.042 和 P=0.002)。基线时为 T1/T2 的对侧眼比 T0 进展更快(P<0.001);T0(T1-T2)组 T3-T5 的年进展率为 9.98%(24.59%)。

结论

对侧眼 MTM 进展的危险因素包括相对年轻时接受 PPV、原发性眼处于高 T 级和对侧眼有部分 PVD。应根据双眼 MTM 的严重程度对对侧眼进行个性化随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d36f/8665302/be672073289d/iovs-62-15-9-f004.jpg

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