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玻璃体切割术治疗孔源性视网膜脱离复位术后的黄斑囊样水肿:发生率、危险因素及预后

Cystoid Macular Edema after Rhegmatogenous Retinal Detachment Repair with Pars Plana Vitrectomy: Rate, Risk Factors, and Outcomes.

作者信息

Merad Malik, Vérité Fabien, Baudin Florian, Ghezala Inès Ben, Meillon Cyril, Bron Alain Marie, Arnould Louis, Eid Pétra, Creuzot-Garcher Catherine, Gabrielle Pierre-Henry

机构信息

Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France.

Agathe Group INSERM U 1150, UMR 7222 CNRS, ISIR (Institute of Intelligent Systems and Robotics), Sorbonne Université, 75005 Paris, France.

出版信息

J Clin Med. 2022 Aug 21;11(16):4914. doi: 10.3390/jcm11164914.

Abstract

(1) Background: The aim was to describe the rate and outcomes of cystoid macular edema (CME) after pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD) and to identify risk factors and imaging characteristics. (2) Methods: A retrospective consecutive case study was conducted over a 5-year period among adult patients who underwent PPV for primary RRD repair. The main outcome measure was the rate of CME at 12 months following PPV. (3) Results: Overall, 493 eyes were included. The CME rate was 28% (93 patients) at 12 months. In multivariate analysis, eyes with worse presenting visual acuity (VA) (odds ratio [OR], 1.55; 95% CI, 1.07-2.25; = 0.02) and grade C proliferative vitreoretinopathy (PVR) (OR, 2.88; 95% CI, 1.04-8.16; = 0.04) were more at risk of developing CME 1 year after PPV. Endolaser retinopexy was associated with a greater risk of CME than cryotherapy retinopexy (OR, 3.06; 95% CI, 1.33-7.84; = 0.01). Eyes undergoing cataract surgery within 6 months of the initial RRD repair were more likely to develop CME at 12 months (OR, 1.96; 95% CI, 1.06-3.63; = 0.03). (4) Conclusions: CME is a common complication after PPV for primary RRD repair. Eyes with worse presenting VA, severe PVR at initial presentation, endolaser retinopexy, and cataract surgery within 6 months of initial RRD repair were risk factors for postoperative CME at 12 months.

摘要

(1) 背景:目的是描述原发性孔源性视网膜脱离(RRD)行玻璃体切割术(PPV)后黄斑囊样水肿(CME)的发生率及预后,并确定危险因素和影像学特征。(2) 方法:对成年原发性RRD修复行PPV的患者进行了一项为期5年的回顾性连续病例研究。主要观察指标是PPV术后12个月时CME的发生率。(3) 结果:共纳入493只眼。12个月时CME发生率为28%(93例患者)。多因素分析显示,初始视力(VA)较差的眼(比值比[OR],1.55;95%可信区间[CI],1.07 - 2.25;P = 0.02)和C级增殖性玻璃体视网膜病变(PVR)(OR,2.88;95% CI,1.04 - 8.16;P = 0.04)在PPV术后1年发生CME的风险更高。眼内激光视网膜光凝术比冷冻疗法视网膜光凝术发生CME的风险更高(OR,3.06;95% CI,1.33 - 7.84;P = 0.01)。在初始RRD修复后6个月内行白内障手术的眼在12个月时更易发生CME(OR,1.96;95% CI,1.06 - 3.63;P = 0.03)。(4) 结论:CME是原发性RRD修复行PPV后的常见并发症。初始VA较差、初始表现为严重PVR、眼内激光视网膜光凝术以及初始RRD修复后6个月内行白内障手术是术后12个月发生CME的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a63/9410086/56b7e1c47135/jcm-11-04914-g001.jpg

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