Department of Ophthalmology, Renmin Hospital of Wuhan University, No. 99 of Zhangzhidong Road, Wuchang District, Wuhan, 430060, China.
BMC Ophthalmol. 2024 Jun 13;24(1):254. doi: 10.1186/s12886-024-03518-2.
The aim of this study is to elucidate the factors contributing to the occurrence of retinal detachment (RD) following prophylactic vitrectomy in cases of acute retinal necrosis (ARN) syndrome.
A retrospective examination was undertaken, encompassing the medical records of patients diagnosed with ARN who underwent prophylactic vitreous intervention at the Ophthalmology Department of Wuhan University Renmin Hospital East Campus between October 2019 and September 2023. Subsequently, patients who manifested RD in the postoperative period were identified, and a comprehensive analysis was conducted to ascertain the factors underlying the occurrence of RD post-surgery.
This study comprised 14 cases (involving 14 eyes) of patients diagnosed with ARN who underwent prophylactic vitreous intervention. The findings revealed that 4 patients experienced postoperative RD, resulting in an incidence rate of 28.57%. Notably, among these cases, 3 cases of RD manifested in the presence of silicone oil, while 1 case occurred subsequent to the removal of silicone oil. All 4 cases of RD exhibited varied degrees of proliferative vitreoretinopathy. Following the occurrence of RD, all patients underwent a secondary vitreous intervention coupled with silicone oil tamponade, leading to successful reattachment of the retina. However, despite these interventions, there was no significant enhancement observed in postoperative visual outcomes when compared to preoperative levels.
RD following prophylactic vitrectomy in cases of ARN is not an infrequent occurrence and is primarily linked to the postoperative onset of proliferative vitreoretinopathy.
本研究旨在阐明急性视网膜坏死(ARN)综合征患者行预防性玻璃体切除术(vitrectomy)后发生视网膜脱离(RD)的相关因素。
回顾性研究了 2019 年 10 月至 2023 年 9 月在武汉大学人民医院东院眼科接受预防性玻璃体干预的 ARN 患者的病历。随后,确定了术后出现 RD 的患者,并进行了全面分析,以确定术后 RD 发生的相关因素。
本研究纳入了 14 例(14 只眼)接受预防性玻璃体干预的 ARN 患者。结果显示,4 例患者术后发生 RD,发生率为 28.57%。值得注意的是,这 4 例 RD 中有 3 例发生在硅油存在的情况下,1 例发生在硅油取出后。所有 4 例 RD 均表现出不同程度的增生性玻璃体视网膜病变。发生 RD 后,所有患者均行二次玻璃体干预联合硅油填充,视网膜成功复位。然而,尽管进行了这些干预,与术前相比,术后视力结果并没有显著改善。
ARN 患者行预防性玻璃体切除术后发生 RD 并不少见,主要与术后发生增生性玻璃体视网膜病变有关。