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玻璃体后皮质中央纤维化:演变与转归

Central posterior hyaloid fibrosis: evolution and outcomes.

作者信息

Venkatesh Ramesh, Handa Ashit, Prabhu Vishma, Chitturi Sai Prashanti, Joshi Aishwarya, Acharya Isha, Mangla Rubble, Yadav Naresh Kumar, Chhablani Jay

机构信息

Dept. of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, 560010, Bengaluru, Karnataka, India.

Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, 203 Lothrop Street, Suite 800, Pittsburg, PA, 15213, USA.

出版信息

Int J Retina Vitreous. 2023 Sep 7;9(1):54. doi: 10.1186/s40942-023-00494-5.

Abstract

PURPOSE

To report contributory factors and clinical outcomes of central posterior hyaloid fibrosis (CPHF) associated with neovascular age-related macular degeneration (nAMD).

METHODS

In this retrospective, single-center study, patients with CPHF and nAMD were included. Demographic and imaging characteristics, as well as the anatomical and functional outcomes, of these patients were analysed.

RESULTS

We identified 530 eyes in 273 patients with chronic predominantly scarred macular neovascularisation (MNV), and 32 eyes in 29 patients revealed CPHF, representing a prevalence of 6%. Patients had a mean age of 72.76 years. Before and during the development of CPHF, Type 2 MNV was observed in all eyes. At the time of MNV diagnosis, mean logMAR visual acuity was 1.308 ± 0.559 (20/407). The average time to develop CPHF was 27.3 months since the diagnosis of MNV. At the time of CPHF identification, the mean logMAR visual acuity was 1.498 ± 0.374 (20/630). RPE tear was observed in 6% (n = 2) of CPHF eyes. The average number of intravitreal anti-VEGF injections administered prior to the diagnosis of CPHF was 2.4 and after the onset of CPHF was 0.9. The final visual acuity was not significantly different at the final follow-up visit [1.304 ± 0.42 (20/402); p = 0.646].

CONCLUSION

Rarely observed in eyes with predominantly scarred subfoveal type 2 MNVs and extensive subretinal fibrosis, CPHF is associated with poor visual outcomes. Its presence could possibly suggest a profibrotic effect of MNV on the posterior hyaloid.

TRIAL REGISTRATION NUMBER

Not applicable.

摘要

目的

报告与新生血管性年龄相关性黄斑变性(nAMD)相关的中心后玻璃体后皮质纤维化(CPHF)的促成因素及临床结局。

方法

在这项回顾性单中心研究中,纳入了患有CPHF和nAMD的患者。分析了这些患者的人口统计学和影像学特征,以及解剖学和功能结局。

结果

我们在273例慢性主要为瘢痕性黄斑新生血管(MNV)患者中识别出530只眼,29例患者中的32只眼出现CPHF,患病率为6%。患者的平均年龄为72.76岁。在CPHF发生之前和期间,所有眼中均观察到2型MNV。在MNV诊断时,平均对数最小分辨角视力为1.308±0.559(20/407)。自MNV诊断以来,发生CPHF的平均时间为27.3个月。在识别出CPHF时,平均对数最小分辨角视力为1.498±0.374(20/630)。在6%(n = 2)的CPHF眼中观察到视网膜色素上皮撕裂。在CPHF诊断之前,玻璃体内抗VEGF注射的平均次数为2.4次,在CPHF发生后为0.9次。在最后一次随访时,最终视力无显著差异[1.304±0.42(20/402);p = 0.646]。

结论

CPHF在主要为瘢痕性黄斑下2型MNV和广泛视网膜下纤维化的眼中很少见,与不良视力结局相关。它的存在可能提示MNV对后玻璃体皮质有促纤维化作用。

试验注册号

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04fc/10486079/7cd3c99ad1a9/40942_2023_494_Fig1_HTML.jpg

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