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同时性黄斑裂孔与并发性视网膜脱离的临床特征和光学相干断层扫描。

Clinical characteristics and optical coherence tomography of concomitant macular hole and rhgematogenous retinal detachment.

机构信息

Department of Ophthalmology, Eye Center, China Medical University Hospital, No. 91, Hsueh Shih Road, Taichung, 404, Taiwan.

Department of Ophthalmology, National Taiwan University Hospital, 7, Chung Shan South Road, Taipei, Taiwan.

出版信息

Sci Rep. 2024 May 26;14(1):12023. doi: 10.1038/s41598-024-61899-2.

DOI:10.1038/s41598-024-61899-2
PMID:38797771
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11128434/
Abstract

To study the clinical characteristics of macula off rhegmatogenous retinal detachment (RRD) with peripheral causative breaks and concomitant macular hole (RRD+MH). This is a bi-center study. Consecutive eyes of macula off RRD with or without macular hole (MH) were collected. Eyes in these two groups were compared with best corrected visual acuity in logarithm of minimal angle of resolution (logMAR BCVA), the presence of choroidal detachment (CD), proliferative vitreoretinopathy (PVR) and the extent of RRD. In the group of RRD+MH, regression analysis was used to evaluate the correlation of clinical factors and final logMar BCVA. In addition, optical coherence tomography was performed both pre-and post-operatively if possible. There were 40 eyes in the RRD+MH group and 80 eyes in the control group. Eyes with RRD+MH had worse initial and final logMar BCVA (p < 0.001), higher incidence of CD (p < 0.001), PVR and extensive RRD at baseline (p < 0.001). Among the eyes with RRD+MH, final BCVA was correlated with initial BCVA (p < 0.001, CI 0.637 to 0.837), recurrent RRD (p = 0.004, CI - 0.661 to - 0.126), duration of RRD (p = 0.021, CI - 0.576 to - 0.048) and presence of PVR (p = 0.001, CI - 0.131 to - 0.035). The hole closure rate at final follow up is 87.5%.11 of the 17 eyes had preoperative optical coherence tomography (OCT) obtained had ellipsoid zone lining the bottom of MH. CD, PVR and extensive RRD were more commonly observed in RRD+MH. The morphology of MH may suggest the pathogenesis of MH in RRD+MH include mechanism different from that of idiopathic MH.

摘要

研究孔源性视网膜脱离(RRD)伴周边裂孔和合并黄斑裂孔(RRD+MH)的临床特征。这是一项双中心研究。收集了伴或不伴黄斑裂孔(MH)的黄斑下 RRD 连续眼。比较两组最佳矫正视力对数最小角分辨率(logMAR BCVA)、脉络膜脱离(CD)、增生性玻璃体视网膜病变(PVR)和 RRD 范围。在 RRD+MH 组中,使用回归分析评估临床因素与最终 logMar BCVA 的相关性。此外,如果可能,还在术前和术后进行光学相干断层扫描(OCT)。RRD+MH 组有 40 只眼,对照组有 80 只眼。RRD+MH 组的初始和最终 logMar BCVA 较差(p<0.001),CD(p<0.001)、PVR 和基线时广泛 RRD 的发生率较高(p<0.001)。在 RRD+MH 组中,最终 BCVA 与初始 BCVA 相关(p<0.001,CI 0.637 至 0.837)、RRD 复发(p=0.004,CI -0.661 至 -0.126)、RRD 持续时间(p=0.021,CI -0.576 至 -0.048)和 PVR 存在(p=0.001,CI -0.131 至 -0.035)。最终随访时孔闭合率为 87.5%。17 只眼中有 11 只术前获得了光学相干断层扫描(OCT),MH 底部有椭圆带。RRD+MH 中更常观察到 CD、PVR 和广泛的 RRD。MH 的形态表明,RRD+MH 中 MH 的发病机制可能与特发性 MH 不同。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f789/11128434/f6e82ee135b2/41598_2024_61899_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f789/11128434/63b215ebcf6e/41598_2024_61899_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f789/11128434/f6e82ee135b2/41598_2024_61899_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f789/11128434/63b215ebcf6e/41598_2024_61899_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f789/11128434/f6e82ee135b2/41598_2024_61899_Fig2_HTML.jpg

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本文引用的文献

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Ophthalmic Surg Lasers Imaging Retina. 2020 Sep 1;51(9):500-505. doi: 10.3928/23258160-20200831-04.
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Macular Hole Formation Secondary to Rhegmatogenous Retinal Detachment Demonstrated With Optical Coherence Tomography.光学相干断层扫描显示孔源性视网膜脱离继发黄斑裂孔形成
Ophthalmic Surg Lasers Imaging Retina. 2019 Jun 1;50(6):e193-e195. doi: 10.3928/23258160-20190605-16.
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Increased Reoperation Rate in Surgical Treatment of Rhegmatogenous Retinal Detachment with Coexistent Macular Hole.
伴有黄斑裂孔的孔源性视网膜脱离手术治疗中再手术率的增加
Ophthalmol Retina. 2018 Mar;2(3):187-191. doi: 10.1016/j.oret.2017.07.005. Epub 2017 Sep 28.
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BMC Ophthalmol. 2016 Aug 9;16:140. doi: 10.1186/s12886-016-0319-9.
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Int J Ophthalmol. 2016 Jul 18;9(7):989-93. doi: 10.18240/ijo.2016.07.09. eCollection 2016.
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