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非近视患者孔源性视网膜脱离合并黄斑裂孔的玻璃体切除术结果

VITRECTOMY RESULTS FOR RHEGMATOGENOUS RETINAL DETACHMENT WITH CONCOMITANT MACULAR HOLE IN NONMYOPIC PATIENTS.

作者信息

Iros Mariano, Sallam Ahmed B, Lopez Juan Manuel, Glacet-Bernard Agnes, Seknazi Daniel, Souied Eric H

机构信息

Instituto de Micro Cirugía Ocular Córdoba, Córdoba, Argentina.

Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and.

出版信息

Retina. 2023 Apr 1;43(4):581-584. doi: 10.1097/IAE.0000000000003742.

Abstract

PURPOSE

To report on results of pars plana vitrectomy with ILM peeling in patients with rhegmatogenous retinal detachment (RRD) and concomitant macular hole (MH) and to assess for preoperative associated conditions related to this type of RRD.

METHODS

Patients undergoing surgical repair for RRD between 2014 and 2021 were reviewed, and subjects with concomitant, non-causal, macular hole were identified. We studied post-operative macular status, retinal reattachment rate and visual acuity.

RESULTS

Over 532 eyes operated on for RRD, 11 (2.06%) had a concurrent non-causal macular hole. Preoperative PVR B or superior was recorded in 86 eyes (16.6%) of the entire cohort and in 6 eyes (54.54 %) with RRD and concomitant MH (p=0.00001). Severe hypotony with choroidal detachment was present in 15 eyes (2.81%) of the entire cohort and in 3 eyes (27.27%) with RRD and concomitant MH (p=<0.00001).

CONCLUSIONS

RRD with concomitant MH is an infrequent association. Retinal reattachment and anatomical hole closure can be achieved in most of cases but despite this fact, functional recovery is usually not good. Preoperative PVR is a more frequent finding in this group of patients, as well as severe hypotony with choroidal detachment.

摘要

目的

报告玻璃体切割联合内界膜剥除术治疗孔源性视网膜脱离(RRD)合并黄斑裂孔(MH)患者的结果,并评估与这类RRD相关的术前合并情况。

方法

回顾2014年至2021年间接受RRD手术修复的患者,确定合并非病因性黄斑裂孔的受试者。我们研究了术后黄斑状态、视网膜复位率和视力。

结果

在532只接受RRD手术的眼中,11只(2.06%)同时存在非病因性黄斑裂孔。整个队列中86只眼(16.6%)术前记录有增殖性玻璃体视网膜病变(PVR)B级或更高级别,RRD合并MH的患者中有6只眼(54.54%)存在该情况(p=0.00001)。整个队列中15只眼(2.81%)出现严重低眼压合并脉络膜脱离,RRD合并MH的患者中有3只眼(27.27%)出现该情况(p<0.00001)。

结论

RRD合并MH是一种罕见的关联情况。大多数病例可实现视网膜复位和解剖学上的裂孔闭合,但尽管如此,功能恢复通常不佳。术前PVR在这类患者中更常见,严重低眼压合并脉络膜脱离也是如此。

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