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3 期或 4 期家族性渗出性玻璃体视网膜病变行晶状体保留玻璃体切除术的解剖学结果。

ANATOMIC OUTCOMES OF LENS-SPARING VITRECTOMY FOR STAGE 3 OR 4 FAMILIAL EXUDATIVE VITREORETINOPATHY.

机构信息

Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China ; and.

Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

出版信息

Retina. 2024 Sep 1;44(9):1538-1545. doi: 10.1097/IAE.0000000000004147. Epub 2024 Aug 16.

Abstract

PURPOSE

To report the anatomic outcomes and retinal structure changes from lens-sparing vitrectomy (LSV) for eyes with Stage 3 or 4 familial exudative vitreoretinopathy (FEVR).

METHODS

Overall, 133 consecutive eyes of 119 patients with Stage 3 (51 eyes) or 4 (82 eyes) FEVR who underwent LSV between January 2012 and May 2023 were retrospectively reviewed.

RESULTS

One hundred twenty-nine eyes (97.0%) achieved traction relief through one LSV operation. The extent of retinal detachment improved in 98 eyes (73.7%), remained stable in 32 eyes (24.1%), and progressed in three eyes (2.3%). At long-term follow-up, 39 (29.3%) and 60 (45.1%) eyes had completely or partially reattached retina, respectively. The median change of venular angle was 3.6° (95% CI, 3.5-10.5; P < 0.001) and -9.9° (95% CI, -15.8 to -4.6; P < 0.001) for temporal and nasal vessels, respectively. The mean disk-fovea distance was 0.3 papillary diameter shorter (95% CI, -0.4 to -0.2; P < 0.001), and the mean temporal venular arcade distance was 0.02 papillary diameter larger (95% CI, -0.16 to 0.21; P = 0.361).

CONCLUSION

These results suggest that LSV can relieve vitreoretinal traction and reattach the retina in late-stage FEVR eyes. Improvements in temporal and nasal venular angle and disk-fovea distance reflect positive retinal structure changes for patients.

摘要

目的

报告晶状体保留玻璃体切除术(LSV)治疗 3 期或 4 期家族性渗出性玻璃体视网膜病变(FEVR)眼的解剖学结果和视网膜结构变化。

方法

回顾性分析 2012 年 1 月至 2023 年 5 月期间接受 LSV 的 119 例患者的 133 只连续眼,其中 3 期(51 只眼)或 4 期(82 只眼)FEVR。

结果

129 只眼(97.0%)通过 1 次 LSV 手术实现牵引松解。98 只眼(73.7%)视网膜脱离程度改善,32 只眼(24.1%)稳定,3 只眼(2.3%)进展。长期随访时,分别有 39 只(29.3%)和 60 只(45.1%)眼视网膜完全或部分再附着。颞侧和鼻侧静脉角的中位数变化分别为 3.6°(95%CI,3.5-10.5;P<0.001)和-9.9°(95%CI,-15.8 至-4.6;P<0.001)。视盘-黄斑中心凹距离缩短 0.3 个视乳头直径(95%CI,-0.4 至-0.2;P<0.001),颞侧静脉弓距离增加 0.02 个视乳头直径(95%CI,-0.16 至 0.21;P=0.361)。

结论

这些结果表明,LSV 可松解晚期 FEVR 眼的玻璃体视网膜牵引并使视网膜再附着。颞侧和鼻侧静脉角以及视盘-黄斑中心凹距离的改善反映了患者视网膜结构的积极变化。

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