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多层反转内界膜瓣技术治疗视盘小凹黄斑病变。

Multilayered Inverted Internal Limiting Membrane Flap Technique in Optic Disc Pit Maculopathy.

机构信息

Bezmialem Vakıf University Faculty of Medicine, Department of Ophthalmology, İstanbul, Türkiye.

出版信息

Turk J Ophthalmol. 2024 Oct 25;54(5):275-281. doi: 10.4274/tjo.galenos.2024.46402.

Abstract

OBJECTIVES

To evaluate the anatomical and visual outcomes of the multilayered inverted internal limiting membrane (ML-ILM) flap technique in the treatment of optic disc pit maculopathy (ODPM).

MATERIALS AND METHODS

In this retrospective interventional case series, medical records and macular spectral-domain optical coherence tomography images of patients who underwent combined pars plana vitrectomy with ML-ILM flap surgery for ODPM were analyzed. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) at postoperative 6 months were compared with baseline findings. Intraoperative and postoperative complications, fluid resolution time, and recurrence during follow-up were recorded.

RESULTS

Five eyes of 5 patients with ODPM were included in the study. According to the preoperative macular fluid characteristics, 2 patients had only intraretinal fluid, while 3 patients had intraretinal and subretinal fluid. The preoperative median BCVA was 1.0 logarithm of the minimum angle of resolution (logMAR) (range, 1.0-1.3 logMAR), and the CMT was 560 μm (range, 452-667 μm). At the 6-month postoperative follow-up, the median BCVA was 0.40 logMAR (range, 0.1-0.7 logMAR), and CMT was 315 μm (range, 265-326 μm) (p=0.042 and p=0.043, respectively). During the 6-month follow-up period, no recurrence or full-thickness macular hole formation was observed.

CONCLUSION

The ML-ILM flap technique is a preferable surgical option to achieve both high anatomical and functional success and flap stabilization.

摘要

目的

评估多层反转内界膜(ML-ILM)瓣技术治疗视盘小凹黄斑病变(ODPM)的解剖和视觉结果。

材料与方法

本回顾性介入病例系列研究分析了接受联合玻璃体切除术和 ML-ILM 瓣手术治疗 ODPM 的患者的病历和黄斑频域光学相干断层扫描图像。比较了术后 6 个月最佳矫正视力(BCVA)和中央黄斑厚度(CMT)与基线的发现。记录了术中及术后并发症、液体积聚消退时间和随访期间的复发情况。

结果

本研究纳入了 5 例 5 只眼 ODPM 患者。根据术前黄斑区积液特点,2 例仅存在视网膜内积液,3 例存在视网膜内和视网膜下积液。术前中位 BCVA 为 1.0 对数最小角分辨率(logMAR)(范围 1.0-1.3 logMAR),CMT 为 560μm(范围 452-667μm)。术后 6 个月随访时,中位 BCVA 为 0.40 logMAR(范围 0.1-0.7 logMAR),CMT 为 315μm(范围 265-326μm)(p=0.042 和 p=0.043)。在 6 个月的随访期间,未观察到复发或全层黄斑裂孔形成。

结论

ML-ILM 瓣技术是一种较好的手术选择,可以实现较高的解剖和功能成功率以及瓣的稳定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a906/11589234/4b3a0218e9f3/TurkJOphthalmol-54-275-figure-1.jpg

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