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与孔源性视网膜脱离伴中心凹脱离术后视力功能相关的因素。

Factors associated with postoperative visual function after rhegmatogenous retinal detachment with foveal detachment.

机构信息

Department of Ophthalmology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya-City, Aichi, Japan.

Department of Ophthalmology, Iida Municipal Hospital, Iida-City, Nagano, Japan.

出版信息

PLoS One. 2024 Sep 20;19(9):e0308863. doi: 10.1371/journal.pone.0308863. eCollection 2024.

Abstract

PURPOSE

To investigate pre-, intra-, and postoperative factors influencing postoperative visual acuity, degree of metamorphopsia, and retinal sensitivity after vitrectomy in patients with rhegmatogenous retinal detachment and foveal detachment.

METHODS

We reviewed retrospectively 33 consecutive eyes of 32 patients, who underwent vitrectomy for rhegmatogenous retinal detachment with foveal detachment between August 2018 and October 2020 and obtained retinal reattachment. Pre-, intra-, and postoperative characteristics were comprehensively analyzed using multivariate models to evaluate the presence of factors influencing best-corrected visual acuity, vertical/horizontal metamorphopsia scores using M-CHARTS (Inami & Co., Ltd., Tokyo, Japan), and retinal sensitivity using the MP-3 (NIDEK Co., Aichi, Japan) at 1-year postoperatively.

RESULTS

Preoperative total retinal detachment was the only factor significantly associated with worse best-corrected visual acuity at 1-year postoperatively (β = 0.589, P<0.001). Intraoperative internal limiting membrane peeling (β = 0.443, P = 0.003) and longer duration after recognizing visual dysfunction (β = 0.425, P = 0.005) were significantly associated with higher vertical metamorphopsia scores at 1 year. The horizontal metamorphopsia score was significantly related to the duration after recognizing visual dysfunction (β = 0.457, P = 0.008). The disappearance of the EZ line on optical coherence tomography at 3 months postoperatively (β = -0.638, P<0.001) was significantly associated with lower retinal sensitivity at 1 year.

CONCLUSIONS

Our study findings suggest that best-corrected visual acuity, metamorphopsia, and retinal sensitivity at 1 year after vitrectomy for rhegmatogenous retinal detachment with foveal detachment are influenced by distinct factors.

摘要

目的

探讨影响孔源性视网膜脱离伴黄斑脱离患者玻璃体切除术后视力、变视症程度和视网膜敏感度的术前、术中及术后因素。

方法

回顾性分析 2018 年 8 月至 2020 年 10 月间 32 例(33 只眼)接受玻璃体切除治疗孔源性视网膜脱离伴黄斑脱离并获得视网膜复位的患者的临床资料。采用多元模型综合分析术前、术中及术后特征,以评估对术后 1 年最佳矫正视力、使用 M-CHARTS(Inami & Co., Ltd.,东京,日本)评估的垂直/水平变视症评分和使用 MP-3(NIDEK Co., Aichi,日本)评估的视网膜敏感度有影响的因素。

结果

术前总视网膜脱离是与术后 1 年最佳矫正视力较差相关的唯一显著因素(β=0.589,P<0.001)。术中内界膜剥除(β=0.443,P=0.003)和发现视力障碍后时间延长(β=0.425,P=0.005)与术后 1 年垂直变视症评分较高显著相关。水平变视症评分与发现视力障碍后时间延长显著相关(β=0.457,P=0.008)。术后 3 个月光学相干断层扫描上 EZ 线消失(β=-0.638,P<0.001)与术后 1 年视网膜敏感度较低显著相关。

结论

本研究结果表明,孔源性视网膜脱离伴黄斑脱离患者玻璃体切除术后 1 年的最佳矫正视力、变视症和视网膜敏感度受不同因素影响。

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