Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Indian J Ophthalmol. 2022 Jan;70(1):171-179. doi: 10.4103/ijo.IJO_3720_20.
: To report the anatomic and visual outcomes following macular buckling in patients affected by pathological myopia-associated foveoschisis (FS) and macular detachment with or without macular hole (MH).
A retrospective interventional consecutive case series wherein 25 highly myopic eyes (mean axial length 28.46 mm; range, 25-33.8 mm) of 24 patients (16 females and 8 males; mean age 54.1 years; range, 35-74 years) presenting with macular detachment associated with a posterior staphyloma (PS), who underwent macular buckling, were evaluated. Patients with absence or reduction in subretinal fluid by more than 90% during the final follow-up along with inversion of contour of staphyloma were considered to have a successful anatomical outcome and those with improvement or maintenance in visual acuity were considered to have a successful functional outcome. The mean duration of follow-up was 11.2 months.
At the time of initial presentation, the mean age of the 24 patients was 54.1 ± 10.28 years. Macular detachment along with FS was present in all cases, whereas full-thickness macular hole-related retinal detachment was present in nine cases. Swept-source optical coherence tomography parameters showed reduction of FS with foveal reattachment in all eyes except one at last visit. Mean axial length decreased from 28.5 mm preoperatively (range 26-33.8 mm) to 26.2 mm (range 24-29.3 mm). The mean best-corrected visual acuity changed from 1.16 log MAR to 1.096 Log MAR (P = 0.165). Visual acuity improved in 10 eyes (40%), remained stable in 11 eyes (44%) and decreased in 4 eyes (16%).
Macular buckling is a good surgical technique with encouraging anatomic and visual outcomes in patients with myopic macular detachment associated with PS. Highly selective cases of myopic traction maculopathy can have a viable option of macular buckle surgery in stabilizing the retinal tractional changes, and thereby, vision loss.
报告病理性近视相关黄斑劈裂（FS）伴或不伴黄斑裂孔（MH）的黄斑脱离患者行黄斑兜带术后的解剖和视力结果。
本研究为回顾性连续病例系列研究，纳入了 24 例（16 名女性和 8 名男性）25 只高度近视眼（平均眼轴长度 28.46mm；范围 25-33.8mm），这些患者因后葡萄肿（PS）相关的黄斑脱离而接受了黄斑兜带手术。末次随访时，如果视网膜下液减少超过 90%，且葡萄肿轮廓反转，则认为解剖学结果成功；如果视力改善或保持稳定，则认为功能学结果成功。平均随访时间为 11.2 个月。
24 例患者的平均年龄为 54.1±10.28 岁。所有患者均存在黄斑脱离伴 FS，9 例存在全层黄斑裂孔相关性视网膜脱离。频域光学相干断层扫描（OCT）参数显示，除 1 例外，所有眼的 FS 均减少且黄斑中心凹复位。平均眼轴长度从术前的 28.5mm（范围 26-33.8mm）缩短至术后的 26.2mm（范围 24-29.3mm）。平均最佳矫正视力从 1.16 对数最小分辨角对数（logMAR）提高至 1.096 LogMAR（P=0.165）。10 只眼（40%）视力提高，11 只眼（44%）视力稳定，4 只眼（16%）视力下降。
对于 PS 相关高度近视性黄斑脱离患者，黄斑兜带术是一种良好的手术技术，具有令人鼓舞的解剖和视力结果。对于高度近视牵引性黄斑病变的选择性病例，黄斑兜带术可以作为一种稳定视网膜牵引性改变的有效方法，从而避免视力丧失。
