Pellegrini Marco, Adamo Ginevra Giovanna, Cartabellotta Antonio, Zanella Maria Sole, Talli Pietro Maria, Nasini Francesco, Sarti Laura, Parmeggiani Francesco, Mura Marco
From the Department of Translational Medicine (M.P., G.A., A.C., M.Z., F.P., M.M.), University of Ferrara, Ferrara, Italy; Department of Ophthalmology (M.P., G.A., A.C., M.Z., P.T., F.N., L.S., F.P., M.M.), Sant'Anna University Hospital, Ferrara, Italy.
From the Department of Translational Medicine (M.P., G.A., A.C., M.Z., F.P., M.M.), University of Ferrara, Ferrara, Italy; Department of Ophthalmology (M.P., G.A., A.C., M.Z., P.T., F.N., L.S., F.P., M.M.), Sant'Anna University Hospital, Ferrara, Italy.
Am J Ophthalmol. 2025 Oct;278:93-98. doi: 10.1016/j.ajo.2025.06.016. Epub 2025 Jun 14.
The purpose of this study was to evaluate the incidence, risk factors and clinical significance of microcystic macular edema (MME) after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).
Interventional case series.
Clinical charts of patients who underwent PPV for RRD were retrospectively reviewed. MME was diagnosed with optical coherence tomography in presence of small, nonconfluent elliptical cystoid spaces located at the level of the inner nuclear layer and sparing other retinal layers and the foveal center. The potential relationship between clinical and surgical variables and the occurrence of MME was evaluated with a multiple logistic regression.
A total of 318 eyes which underwent PPV for RRD were included. In total, 35 eyes (11.0%) presented cystoid changes consistent with MME, while 93 (29.2%) showed "typical" cystoid macular edema. Silicone oil tamponade was significantly associated with the occurrence of MME (P = .010). Best-corrected visual acuity did not differ significantly between eyes with and without MME (0.44 ± 0.54 versus 0.71 ± 0.76 logMAR; P = .103).
This study found an incidence of 11% of MME following vitrectomy for RRD. Although MME was significantly associated with silicone oil tamponade, it showed no relationship with postoperative visual outcomes. Thus, no anti-inflammatory treatment may be required.
本研究旨在评估孔源性视网膜脱离（RRD）行玻璃体切割术（PPV）后微囊性黄斑水肿（MME）的发生率、危险因素及临床意义。
干预性病例系列研究。
回顾性分析接受PPV治疗RRD患者的临床病历。通过光学相干断层扫描诊断MME，表现为位于内核层水平的小的、不融合的椭圆形囊样间隙，不累及其他视网膜层和黄斑中心。采用多元逻辑回归评估临床和手术变量与MME发生之间的潜在关系。
共纳入318只接受PPV治疗RRD的眼。总共35只眼（11.0%）出现符合MME的囊样改变，而93只眼（29.2%）表现为“典型”的囊样黄斑水肿。硅油填充与MME的发生显著相关（P = 0.010）。有无MME的眼之间最佳矫正视力差异无统计学意义（0.44±0.54对0.71±0.76 logMAR；P = 0.103）。
本研究发现RRD玻璃体切除术后MME的发生率为11%。虽然MME与硅油填充显著相关，但与术后视力结果无关。因此，可能无需抗炎治疗。
