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视网膜静脉阻塞继发黄斑水肿患者中浆液性黄斑脱离的患病率。

Prevalence of Serous Macular Detachment in Recurrent Macular Edema Secondary to Retinal Vein Occlusion.

机构信息

University of Health Sciences Turkey, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey.

Kudret Eye Hospital, Ankara, Turkey.

出版信息

Turk J Ophthalmol. 2022 Aug 25;52(4):276-280. doi: 10.4274/tjo.galenos.2021.02582.

Abstract

OBJECTIVES

To evaluate the prevalence of serous macular detachment (SMD) accompanying recurrent cystoid macular edema (CME) in patients initially treated for CME secondary to retinal vein occlusion (RVO) with accompanying SMD, and discuss the factors that affect the prevalence.

MATERIALS AND METHODS

We retrospectively evaluated the medical records of 71 patients with RVO-associated CME and SMD who achieved complete anatomical resolution after treatment with either a single dexamethasone implant or three loading doses of ranibizumab and developed recurrent CME during follow-up.

RESULTS

Initial treatment was a single intravitreal dexamethasone implant in 45 patients (63.4%) (Group 1) and three loading doses of intravitreal ranibizumab in 26 patients (36.6%) (Group 2). The mean time to CME recurrence was 4.7±0.8 months (range, 4-7 months) and was similar in both groups (p=0.984). At the time of CME recurrence, SMD was present in 41 patients (57.7%) and absent in 30 patients (42.3%). SMD was present in 27 (60.0%) of the 45 Group 1 patients and 14 (53.8%) of the 26 Group 2 patients (p=0.613). SMD was present in 48.8% of branch RVO and 71.4% of central RVO patients at the time of recurrence (p<0.001).

CONCLUSION

SMD accompanied recurrent CME in only 57.7% of patients previously treated for CME and SMD and seems to be more frequent in patients with central RVO. Initial intravitreal treatment choice of either ranibizumab or dexamethasone implant did not affect the prevalence of concurrent SMD in patients with recurrent CME.

摘要

目的

评估最初因伴有浆液性黄斑脱离(SMD)的视网膜静脉阻塞(RVO)继发的黄斑水肿(CME)而接受治疗且 CME 完全解剖学缓解的患者中,反复发生 CME 时并发 CME 的发生率,并探讨影响这一发生率的相关因素。

材料与方法

我们回顾性评估了 71 例因 RVO 相关 CME 和 SMD 而接受治疗且 CME 完全解剖学缓解的患者的病历资料,这些患者在随访期间出现反复 CME 后,分别接受了单次玻璃体内曲安奈德植入(45 例,63.4%)或三次玻璃体内雷珠单抗负荷剂量治疗(26 例,36.6%)。

结果

初始治疗为单次玻璃体内曲安奈德植入的患者有 45 例(63.4%)(第 1 组),三次玻璃体内雷珠单抗负荷剂量治疗的患者有 26 例(36.6%)(第 2 组)。CME 复发的平均时间为 4.7±0.8 个月(范围 4-7 个月),两组之间无显著差异(p=0.984)。在 CME 复发时,41 例(57.7%)患者存在 SMD,30 例(42.3%)患者不存在 SMD。第 1 组中,27 例(60.0%)患者存在 SMD,14 例(53.8%)患者不存在 SMD;第 2 组中,27 例(60.0%)患者存在 SMD,14 例(53.8%)患者不存在 SMD。两组之间无显著差异(p=0.613)。在 CME 复发时,SMD 存在于 48.8%的分支 RVO 患者和 71.4%的中央 RVO 患者中(p<0.001)。

结论

在先前接受 CME 和 SMD 治疗的患者中,仅有 57.7%的患者出现反复 CME 时伴有 SMD,且在中央 RVO 患者中似乎更为常见。在出现反复 CME 的患者中,初始玻璃体内治疗选择雷珠单抗或曲安奈德植入均不影响 SMD 的并发率。

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Graefes Arch Clin Exp Ophthalmol. 2013 Jan;251(1):9-14. doi: 10.1007/s00417-012-2023-7. Epub 2012 Apr 25.

本文引用的文献

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Ranibizumab for serous macular detachment in branch retinal vein occlusions.雷珠单抗治疗视网膜分支静脉阻塞性浆液性黄斑脱离。
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