Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum University of Bologna, Bologna, Italy.
IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9 Bologna,, Bologna, Postal code, 40138, Italy.
BMC Ophthalmol. 2024 Jul 16;24(1):287. doi: 10.1186/s12886-024-03559-7.
To report real-world outcomes of patients with primary Reghmatogenous Retinal Detachment (RRD) treated with Pneumatic Retinopexy (PnR) according to the indications of the Pneumatic Retinopexy versus Vitrectomy for management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT) trial.
Multicenter, retrospective study. Patients treated with PnR for RRD between 2021 and 2023 and a follow-up of at least 6 months were included. Single-procedure anatomical success, final anatomical success, complications, causes of failures, best corrected visual acuity (BCVA) after surgery, and the vision-related quality of life using the 25-Item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) were reported.
A total of 76 eyes of 76 patients were included. Mean age was 60 ± 8.1 years. Primary anatomic reattachment was achieved by 84.3% of patients and final anatomical reattachment after pars plana vitrectomy was obtained in 100% of patients. BCVA improved from 0.32 (20/40) to 0.04 (20/20) logMar (p < 0.001) at 6 months. The main cause of failure was related to the presence of additional (likely missed) retinal breaks (66.6% of cases). Also, primary PnR failure was more frequent in eyes of patients with older age, macular involvement, worse baseline BCVA, greater extent of the RRD, and increased duration from diagnosis to treatment. Overall, the mean NEI-VFQ 25 composite score was 93.9% ± 6.4 at 6 months.
The criteria of the PIVOT trial can be applied to real-world scenarios in the decision-making process for the treatment of primary RRD, with excellent anatomical and functional outcomes.
报告根据 Pneumatic Retinopexy versus Vitrectomy for management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial（PIVOT）试验的适应证，接受 Pneumatic Retinopexy（PnR）治疗的原发性孔源性视网膜脱离（RRD）患者的真实世界结局。
多中心回顾性研究。纳入 2021 年至 2023 年期间接受 PnR 治疗的 RRD 患者，且随访时间至少 6 个月。报告单次手术解剖成功率、最终解剖成功率、并发症、失败原因、术后最佳矫正视力（BCVA）和使用 25 项国家眼科研究所视觉功能问卷（NEI VFQ-25）评估的视力相关生活质量。
共纳入 76 例 76 眼患者。平均年龄为 60±8.1 岁。84.3%的患者初次解剖复位，100%的患者行玻璃体切除术以获得最终解剖复位。BCVA 从 0.32（20/40）提高至 0.04（20/20）logMar（p<0.001），术后 6 个月。失败的主要原因与存在额外（可能漏诊）视网膜裂孔有关（66.6%的病例）。此外，在年龄较大、黄斑受累、基线 BCVA 较差、RRD 范围较大和从诊断到治疗的时间延长的患者中，初次 PnR 失败更为常见。总体而言，术后 6 个月的平均 NEI-VFQ 25 综合评分 93.9%±6.4。
在原发性 RRD 的治疗决策过程中，可应用 PIVOT 试验的标准，获得良好的解剖和功能结局。
