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遗传性视网膜疾病的玻璃体切除术:文献综述

Pars Plana Vitrectomy in Inherited Retinal Diseases: A Comprehensive Review of the Literature.

作者信息

Iovino Claudio, Rosolia Andrea, Damiano Luciana, Iodice Clemente Maria, Di Iorio Valentina, Testa Francesco, Simonelli Francesca

机构信息

Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy.

出版信息

Life (Basel). 2023 May 24;13(6):1241. doi: 10.3390/life13061241.

Abstract

Inherited retinal diseases (IRDs) are a group of clinically and genetically heterogeneous disorders that may be complicated by several vitreoretinal conditions requiring a surgical approach. Pars plana vitrectomy (PPV) stands as a valuable treatment option in these cases, but its application in eyes with such severely impaired chorioretinal architectures remains controversial. Furthermore, the spreading of gene therapy and the increasing use of retinal prostheses will end up in a marked increase in demand for PPV surgery for IRD patients. The retinal degeneration that typically affects patients with hereditary retinal disorders may influence the execution of the surgery and the expected results. Considering the importance of PPV application in IRD-related complications, it is fundamental to try to understand from the literature what is adequate and safe in posterior eye segment surgery. Use of dyes, light toxicity, and risk of wounding scar development have always been themes that discourage the execution of vitreoretinal surgery in already impaired eyes. Therefore, this review aims to comprehensively summarize all PPV applications in different IRDs, highlighting the favorable results as well as the potential precautions to consider when performing vitreoretinal surgery in these eyes.

摘要

遗传性视网膜疾病(IRDs)是一组临床和遗传异质性疾病,可能并发多种需要手术治疗的玻璃体视网膜疾病。在这些情况下,玻璃体切割术(PPV)是一种有价值的治疗选择,但其在脉络膜视网膜结构严重受损的眼中的应用仍存在争议。此外,基因治疗的推广和视网膜假体的日益使用,最终将导致IRD患者对PPV手术的需求显著增加。通常影响遗传性视网膜疾病患者的视网膜变性可能会影响手术的实施和预期效果。考虑到PPV在IRD相关并发症中的应用的重要性,从文献中了解后段眼部手术中哪些是合适且安全的是至关重要的。染料的使用、光毒性和伤口瘢痕形成的风险一直是阻碍在已经受损的眼睛中进行玻璃体视网膜手术的问题。因此,本综述旨在全面总结PPV在不同IRD中的所有应用,突出有利结果以及在这些眼中进行玻璃体视网膜手术时需要考虑的潜在注意事项。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4145/10305349/7dd3659d15bc/life-13-01241-g001.jpg

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