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高危格状变性眼激光视网膜凝固术的适应证及治疗效果

Indications and Outcomes of Laser Retinopexy in Eyes With High-Risk Lattice Degeneration.

作者信息

Kazan Adina S, Mahmoudzadeh Raziyeh, Salabati Mirataollah, Sharpe James, Fineman Mitchell S, Hsu Jason, Yonekawa Yoshihiro, Spirn Marc J

机构信息

Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, PA, USA.

Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA, USA.

出版信息

J Vitreoretin Dis. 2024 Apr 25;8(4):381-387. doi: 10.1177/24741264241248253. eCollection 2024 Jul-Aug.

Abstract

To examine the characteristics of eyes with high-risk lattice degeneration treated with laser retinopexy and determine the indications, safety, and outcomes of the treatment. This interventional single-surgeon consecutive retrospective study was conducted at Wills Eye Hospital between 2014 and 2021. The series included eyes with lattice degeneration with high-risk lesions. Documented characteristics and outcomes of these eyes and fellow eyes were documented. The study comprised 167 eyes of 143 patients (53.3% women; mean age [±SD], 50 ± 17 years). Complications after laser treatment included new posterior vitreous detachment (PVD) (n = 21), epiretinal membrane (ERM) (n = 13), retinal detachment (RD) (n = 5), and additional laser required (n = 22). Eyes that developed ERMs were more likely to develop PVDs (odds ratio, 5.39; 95% CI, 1.57-18.47). Patents who developed ERMs were older (mean, 60 ± 7 years vs 49 ± 17 years;  = .016), as were those developing PVDs (mean, 59 ± 8 years vs 48 ± 17;  = .005). No eye with a new ERM required surgery (n = 13). Four eyes with a new RD required laser retinopexy alone; 1 eye was treated surgically. No eye had an RD at the most recent evaluation. Despite high-risk lesions in areas of lattice degeneration, few eyes developed RDs after prophylactic laser retinopexy. Older patients may have a higher risk for ERM or PVD after laser treatment. Eyes with post-laser PVD were more likely to develop an ERM.

摘要

为了研究接受激光视网膜固定术治疗的高危格子样变性眼的特征,并确定该治疗的适应症、安全性和疗效。这项单医生连续回顾性干预研究于2014年至2021年在威尔斯眼科医院进行。该系列研究纳入了伴有高危病变的格子样变性眼。记录了这些患眼及其对侧眼的特征和治疗结果。该研究包括143例患者的167只眼(女性占53.3%;平均年龄[±标准差],50±17岁)。激光治疗后的并发症包括新发性玻璃体后脱离(PVD)(n = 21)、视网膜前膜(ERM)(n = 13)、视网膜脱离(RD)(n = 5)以及需要再次激光治疗(n = 22)。发生ERM的眼更易发生PVD(比值比,5.39;95%可信区间,1.57 - 18.47)。发生ERM的患者年龄较大(平均,60±7岁对49±17岁;P = 0.016),发生PVD的患者也是如此(平均,59±8岁对48±17岁;P = 0.005)。没有一只新发ERM的眼需要手术治疗(n = 13)。4只新发RD的眼仅需激光视网膜固定术治疗;1只眼接受了手术治疗。在最近一次评估时没有眼发生RD。尽管格子样变性区域存在高危病变,但预防性激光视网膜固定术后很少有眼发生RD。老年患者激光治疗后发生ERM或PVD的风险可能更高。激光治疗后发生PVD的眼更易发生ERM。

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