曲安奈德辅助可视化及清除视网膜脱离中的玻璃体皮质残留:一项前瞻性队列研究
Triamcinolone Acetonide-Assisted Visualization and Removal of Vitreous Cortex Remnants in Retinal Detachment: A Prospective Cohort Study.
作者信息
Faraldi Francesco, Lavia Carlo Alessandro, Bacherini Daniela, Rizzo Clara, Savastano Maria Cristina, Nassisi Marco, Ferrara Mariantonia, Romano Mario R, Rizzo Stanislao
机构信息
Ophthalmology Unit, Surgical Department, A.O. Ordine Mauriziano,10128 Turin, Italy.
Department of Neurosciences, Psychology, Drug Research, and Child Health, Eye Clinic, Azienda Ospedaliero Universitaria Careggi, University of Florence, 50134 Florence, Italy.
出版信息
Diagnostics (Basel). 2025 Jul 23;15(15):1854. doi: 10.3390/diagnostics15151854.
: In rhegmatogenous retinal detachment (RRD), vitreous cortex remnants (VCRs) may contribute to the development and progression of proliferative vitreoretinopathy (PVR). This study aimed to evaluate potential toxicity and trauma secondary to VCRs visualization and removal during pars plana vitrectomy (PPV) for RRD. : Prospective study on patients with primary RRD who underwent PPV. Imaging assessment included widefield OCT (WF-OCT), ultra-WF retinography and fundus autofluorescence (FAF). During PPV, a filtered and diluted triamcinolone acetonide (TA) solution (20 mg/mL) was used to evaluate the presence and extension of VCRs, removed using an extendible diamond-dusted sweeper (EDDS). After six months, retinal and retinal pigment epithelium toxicity and retinal trauma due to VCRs removal were investigated. : Retinal reattachment was achieved in 21/21 cases included in the study. No signs of retinal or RPE toxicity were detected and WF-OCT performed in the areas of VCRs removal revealed an intact inner retinal architecture in the majority of eyes, with minor and localized inner retinal indentations in 4 cases. : VCRs visualization and removal using TA and EDDS appears to be safe, with no retinal toxicity and very limited and circumscribed mechanical trauma. This approach may contribute to reducing the risk of postoperative PVR.
在孔源性视网膜脱离(RRD)中,玻璃体皮质残余物(VCRs)可能促进增殖性玻璃体视网膜病变(PVR)的发生和发展。本研究旨在评估在RRD的玻璃体切割术(PPV)期间VCRs可视化及切除继发的潜在毒性和创伤。
对接受PPV的原发性RRD患者进行前瞻性研究。影像学评估包括广角光学相干断层扫描(WF-OCT)、超广角视网膜造影和眼底自发荧光(FAF)。在PPV期间,使用过滤并稀释的曲安奈德(TA)溶液(20mg/mL)评估VCRs的存在及范围,使用可伸展的金刚石粉清扫器(EDDS)将其切除。六个月后,研究VCRs切除导致的视网膜和视网膜色素上皮毒性及视网膜创伤。
本研究纳入的21例患者均实现视网膜复位。未检测到视网膜或视网膜色素上皮毒性迹象,在VCRs切除区域进行的WF-OCT显示,大多数眼内视网膜结构完整,4例存在轻微局限性视网膜内凹。
使用TA和EDDS对VCRs进行可视化及切除似乎是安全的,无视网膜毒性,机械创伤非常有限且局限。这种方法可能有助于降低术后PVR的风险。