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高度近视性黄斑裂孔性视网膜脱离行黄斑兜带术后的视功能和变形觉结果。

VISION AND METAMORPHOPSIA OUTCOMES OF MACULAR BUCKLING FOR FOVEOSCHISIS-ASSOCIATED MACULAR DETACHMENT IN HIGHLY MYOPIC EYES.

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.

出版信息

Retina. 2024 Sep 1;44(9):1546-1551. doi: 10.1097/IAE.0000000000004148. Epub 2024 Aug 16.

Abstract

PURPOSE

To assess the functional outcomes in visual acuity, metamorphopsia, and vision-related quality of life (VR-QOL) and to evaluate prognostic factors after macular buckling (MB) surgery in eyes with high myopia and foveoschisis (FS)-associated macular detachment (MD).

METHODS

Thirty-nine eyes of 39 patients with FS-associated MD who underwent MB surgery were enrolled. Measured outcomes comprised best-corrected visual acuity (BCVA), metamorphopsia, VR-QOL, axial length (AL), macular reattachment, and resolution of foveoschisis. In addition, factors affecting final BCVA and metamorphopsia were analyzed.

RESULTS

At 12 months postoperatively, 36 eyes (92.31%) achieved macular reattachment, 37 eyes (94.87%) achieved complete resolution of foveoschisis, and metamorphopsia diminished in 31 eyes (79.49%). LogMAR BCVAs at baseline and months 1, 3, 6, and 12 postoperatively were 0.62 ± 0.35 (20/83), 0.65 ± 0.3 (20/89), 0.59 ± 0.31 (20/77), 0.54 ± 0.31 (20/69), and 0.46 ± 0.27 (20/57) (P < 0.001), respectively. Metamorphopsia scores by M-CHARTS were 1.36° ± 0.51°, 1.04° ± 0.51°, 0.74° ± 0.47°, 0.59° ± 0.47°, and 0.13° ± 0.29° (P < 0.001). All Visual Function Questionnaire-25 subscales demonstrated significant improvement postoperatively, with the exception of "general health" (P = 0.08) and "driving" (P = 0.111). Preoperative BCVA was an independent risk factor for postoperative BCVA at month 12 (r = 0.638, P < 0.001), and the preoperative M-score was an independent risk factor for postoperative M-score at month 12 (r = 0.187, P = 0.045).

CONCLUSION

MB surgery significantly improved BCVA, metamorphopsia, and VR-QOL in patients with FS-associated MD. Preoperative BCVA and metamorphopsia score were prognostic factors for postoperative BCVA and metamorphopsia score at month 12.

摘要

目的

评估高度近视伴黄斑劈裂(FS)相关黄斑脱离(MD)患者行黄斑兜带术(MB)后的视力、视物变形和视觉相关生活质量(VR-QOL)的功能结果,并分析相关预后因素。

方法

回顾性分析 39 例(39 只眼)FS 相关 MD 患者行 MB 术后的随访资料。主要观察指标包括最佳矫正视力(BCVA)、视物变形、VR-QOL、眼轴长度(AL)、黄斑复位和 FS 劈裂的完全复位。同时,分析影响最终 BCVA 和视物变形的因素。

结果

术后 12 个月,36 只眼(92.31%)黄斑复位,37 只眼(94.87%)FS 劈裂完全复位,31 只眼(79.49%)视物变形减轻。术前及术后 1、3、6、12 个月 LogMAR BCVA 分别为 0.62 ± 0.35(20/83)、0.65 ± 0.3(20/89)、0.59 ± 0.31(20/77)、0.54 ± 0.31(20/69)和 0.46 ± 0.27(20/57)(P < 0.001)。M-CHARTS 评估的视物变形评分分别为 1.36° ± 0.51°、1.04° ± 0.51°、0.74° ± 0.47°、0.59° ± 0.47°和 0.13° ± 0.29°(P < 0.001)。术后除“一般健康”(P = 0.08)和“驾驶”(P = 0.111)外,所有视觉功能问卷-25 子量表均有显著改善。术前 BCVA 是术后 12 个月 BCVA 的独立危险因素(r = 0.638,P < 0.001),术前 M 评分是术后 12 个月 M 评分的独立危险因素(r = 0.187,P = 0.045)。

结论

MB 手术可显著提高 FS 相关 MD 患者的 BCVA、视物变形和 VR-QOL。术前 BCVA 和视物变形评分是术后 12 个月 BCVA 和视物变形评分的预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11eb/11332366/9912184b1796/retina-44-1546-g001.jpg

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