Arend Nicole, Vounotrypidis Efstathios, Schumann Ricarda G, Kampik Anselm, Lob Felice, Priglinger Siegfried, Wolf Armin
Department of Ophthalmology, Eye Center Olching, Olching, Germany.
Department of Ophthalmology, Ulm University, Ulm, Germany.
Clin Ophthalmol. 2024 Aug 13;18:2261-2270. doi: 10.2147/OPTH.S463004. eCollection 2024.
To evaluate optical-coherence-tomography (OCT)-morphological and clinical parameters three years after primary rhegmatogenous retinal detachment (RRD) repair surgery and the role of postoperative foveal bulge sign.
Of the 32 initially enrolled patients with primary RRD 20 (14 fovea-on, 6 fovea-off) completed this prospective study. Preoperatively and 3 years after surgery best corrected visual acuity (BCVA) and OCT including macula status, central retinal thickness (CRT), central choroidal thickness (CCT), thickness of each single retinal layer, integrity of cone-interdigitation-zone (CIZ) and ellipsoid zone (EZ), and presence of foveal bulge were evaluated.
Preoperatively fovea-off RRD patients show significantly thinner CCT, inner nuclear layer (INL) and inner plexiform layer (IPL) compared to fovea-on RRD patients, whereas only IPL and INL were significantly thicker compared to the fellow eye. Three years after surgery this thickening recovered. Final BCVA did not differ statistically significantly between fovea-off and fovea-on patients, no difference in CIZ-integrity or presence of foveal bulge was observed. Presence of foveal bulge at 3 years showed significantly better final BCVA and was associated with intact preoperative CIZ-integrity and postoperative EZ- and CIZ-integrity. The preoperative fovea status showed no correlation to the postoperative presence of foveal bulge.
Three years after RRD repair retinal layers show similar thickness. The presence of foveal bulge is associated with better final BCVA. Sufficient pre- and postoperative CIZ-integrity as well as postoperative CIZ-integrity seem to be strongly associated with the restoration of foveal bulge. No correlation was found with the preoperative macular status or BCVA.
评估原发性孔源性视网膜脱离（RRD）修复手术后三年的光学相干断层扫描（OCT）形态学和临床参数，以及术后黄斑隆起征的作用。
32例最初纳入的原发性RRD患者中，20例（14例黄斑在位，6例黄斑脱离）完成了这项前瞻性研究。术前及术后3年评估最佳矫正视力（BCVA）和OCT，包括黄斑状态、中心视网膜厚度（CRT）、中心脉络膜厚度（CCT）、各视网膜单层厚度、锥体细胞交错带（CIZ）和椭圆体带（EZ）的完整性，以及黄斑隆起的存在情况。
术前黄斑脱离的RRD患者与黄斑在位的RRD患者相比，CCT、内核层（INL）和内丛状层（IPL）明显更薄，而与对侧眼相比，只有IPL和INL明显更厚。术后三年这种增厚情况恢复。黄斑脱离和黄斑在位患者的最终BCVA在统计学上没有显著差异，未观察到CIZ完整性或黄斑隆起存在情况的差异。术后3年存在黄斑隆起的患者最终BCVA明显更好，且与术前CIZ完整性完好以及术后EZ和CIZ完整性相关。术前黄斑状态与术后黄斑隆起的存在情况无相关性。
RRD修复术后三年视网膜各层厚度相似。黄斑隆起的存在与更好的最终BCVA相关。术前和术后足够的CIZ完整性以及术后CIZ完整性似乎与黄斑隆起的恢复密切相关。未发现与术前黄斑状态或BCVA相关。
