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糖尿病性牵拉性视网膜脱离黄斑区玻璃体切割术后持续性视网膜下液的临床分析

Clinical Analysis of Persistent Subretinal Fluid after Pars Plana Vitrectomy in Macula with Diabetic Tractional Retinal Detachment.

作者信息

Kang Yong-Koo, Shin Jae-Pil

机构信息

Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu 41944, Korea.

出版信息

J Clin Med. 2021 Dec 17;10(24):5929. doi: 10.3390/jcm10245929.

Abstract

(1) Background: We analyzed the duration of persistent subretinal fluid (PSF) and the contributing factors of PSF after pars plana vitrectomy in patients who had a macula with diabetic tractional retinal detachment (TRD). (2) Methods: Forty eyes of 40 patients who had pars plana vitrectomy due to a macula with diabetic TRD, between 2014 and 2020, were retrospectively reviewed. The duration of PSF, as well as relevant ocular and systemic factors, was analyzed. (3) Results: The mean duration of PSF was 4.4 ± 4.7 months. The prevalence of PSF was 75.0% at 1 month, 50.0% at 3 months, 30.0% at 6 months and 10.0% at 12 months after surgery. Blood urea nitrogen, creatinine, and estimated glomerular filtration rate (eGFR) were significantly associated with the duration of PSF in the univariate analysis. In the multivariate analysis, only eGFR was significantly associated with the duration of PSF ( = -0.089, = 0.030). (4) Conclusion: PSF may persist for more than 12 months in a macula with diabetic TRD after vitrectomy. Moreover, patients with impaired kidney function tended to have a delayed subretinal fluid absorption. Therefore, careful investigation of preoperative systemic conditions, especially kidney function, should be considered before TRD surgery in diabetic patients.

摘要

(1) 背景:我们分析了患有黄斑部糖尿病性牵拉性视网膜脱离(TRD)的患者在玻璃体切除术后持续性视网膜下液(PSF)的持续时间及相关影响因素。(2) 方法:回顾性分析了2014年至2020年间因黄斑部糖尿病性TRD接受玻璃体切除术的40例患者的40只眼。分析了PSF的持续时间以及相关的眼部和全身因素。(3) 结果:PSF的平均持续时间为4.4±4.7个月。术后1个月PSF的发生率为75.0%,3个月时为50.0%,6个月时为30.0%,12个月时为10.0%。在单因素分析中,血尿素氮、肌酐和估计肾小球滤过率(eGFR)与PSF的持续时间显著相关。在多因素分析中,只有eGFR与PSF的持续时间显著相关(=-0.089,=0.030)。(4) 结论:玻璃体切除术后,患有黄斑部糖尿病性TRD的患者PSF可能持续超过12个月。此外,肾功能受损的患者视网膜下液吸收往往延迟。因此,糖尿病患者在TRD手术前应仔细评估术前全身状况,尤其是肾功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15a6/8709087/bf860f776c04/jcm-10-05929-g001.jpg

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