Lu Nan, Yang Shi-Lin, Guo Shuo, Yang Dong-Ni, Liu Li, Fan Chun-Hui, Guo Ying, Liu Jian, Zhao Wei
Department of Ophthalmology, the First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei Province, China.
School of Control Engineering, Northeastern University at Qinhuangdao, Qinhuangdao 066004, Hebei Province, China.
Int J Ophthalmol. 2024 Aug 18;17(8):1462-1468. doi: 10.18240/ijo.2024.08.11. eCollection 2024.
To analyze the distribution of fibrovascular proliferative membranes (FVPMs) in proliferative diabetic retinopathy (PDR) patients that treated with pars plana vitrectomy (PPV), and to evaluate the outcomes separately.
This was a retrospective and cross-sectional study. Consecutive 25-gauge (25-G) PPV cases operated for PDR from May 2018 to April 2020. According to the FVPMs images outlined after operations, subjects were assigned into three groups: arcade type group, juxtapapillary type group, and central type group. All patients were followed up for over one year. General characteristics, operation-related variables, postoperative parameters and complications were recorded.
Among 103 eyes recruited, the FVPMs distribution of nasotemporal and inferiosuperioral was significantly different (both <0.01), with 95 (92.23%) FVPMs located in the nasal quadrants, and 74 (71.84%) in the inferior. The eyes with a central FVPM required the longest operation time, with silicon oil used in most patients, generally combined with tractional retinal detachment (RD) and rhegmatogenous RD, the worst postoperative best-corrected visual acuity (BCVA) and the highest rates of recurrent RD (all <0.05). FVPM type, age of onset diabetes mellitus, preoperative BCVA, and combined with tractional RD and rhegmatogenous RD were significantly associated with BCVA improvement (all <0.05). Compared with the central type group, the arcade type group had higher rates of BCVA improvement.
FVPMs are more commonly found in the nasal and inferior mid-peripheral retina in addition to the area of arcade vessels. Performing 25-G PPV for treating PDR eyes with central FVPM have relatively worse prognosis.
分析接受玻璃体切割术（PPV）治疗的增殖性糖尿病视网膜病变（PDR）患者中纤维血管增殖膜（FVPMs）的分布情况，并分别评估其预后。
这是一项回顾性横断面研究。纳入2018年5月至2020年4月间连续接受25G PPV手术治疗PDR的患者。根据术后勾勒出的FVPMs图像，将受试者分为三组：弓状血管型组、视乳头旁型组和中央型组。所有患者均随访一年以上。记录患者的一般特征、手术相关变量、术后参数及并发症。
在纳入的103只眼中，FVPMs在鼻颞侧和下上侧的分布有显著差异（均<0.01），95只眼（92.23%）的FVPMs位于鼻侧象限，74只眼（71.84%）位于下方。中央型FVPM的眼手术时间最长，大多数患者使用硅油，通常合并牵引性视网膜脱离（RD）和孔源性RD，术后最佳矫正视力（BCVA）最差，RD复发率最高（均<0.05）。FVPM类型、糖尿病发病年龄、术前BCVA以及合并牵引性RD和孔源性RD与BCVA改善显著相关（均<0.05）。与中央型组相比，弓状血管型组BCVA改善率更高。
除弓状血管区域外，FVPMs更常见于鼻侧和下周边视网膜中部。对中央型FVPM的PDR眼行25G PPV治疗预后相对较差。
