Pendergast S D, Martin D F, Proia A D, Jaffe G J, McCuen B W
Duke University Eye Center, Durham, North Carolina 27710, USA.
Retina. 1995;15(1):25-8. doi: 10.1097/00006982-199515010-00005.
The morphologic features and clinical consequences of removing residual optic disc stalks during vitrectomy for complications of diabetic retinopathy have not been described.
Twenty-four residual optic disc stalks that were surgically removed from eyes with proliferative diabetic retinopathy and dense nonclearing vitreous hemorrhage and/or traction retinal detachment were studied histologically using conventional hematoxylin and eosin staining as well as a modified Glees staining technique.
Histologic examination demonstrated that 79% of the specimens consisted of vascularized glial tissue with an infiltrate of mononuclear cells and 21% consisted of glial membranes devoid of vasculature. Axons were identified in 33% of all tissues studied. Intra-operative hemorrhage occurred in three eyes with strongly adherent optic disc stalks and was controlled with transient elevation of the intraocular pressure. The presence of axons in the removed optic disc stalks was not correlated with a decreased final postoperative visual acuity (median time to follow-up 21 months).
Residual optic disc stalks removed during vitrectomy for proliferative diabetic retinopathy frequently contained axons. The presence of axons does not portend an unfavorable postoperative visual outcome.
在糖尿病性视网膜病变并发症的玻璃体切除术中，切除残留视盘柄的形态学特征及临床后果尚未见报道。
对24例从患有增殖性糖尿病性视网膜病变且伴有浓密不吸收的玻璃体出血和/或牵拉性视网膜脱离的眼中手术切除的残留视盘柄进行组织学研究，采用常规苏木精-伊红染色以及改良的格利斯染色技术。
组织学检查显示，79%的标本由伴有单核细胞浸润的血管化神经胶质组织组成，21%由无血管的神经胶质膜组成。在所研究的所有组织中，33%鉴定出有轴突。3例视盘柄紧密粘连的眼术中发生出血，通过短暂升高眼压得以控制。切除的视盘柄中轴突的存在与术后最终视力下降无关（中位随访时间21个月）。
在增殖性糖尿病性视网膜病变的玻璃体切除术中切除的残留视盘柄常含有轴突。轴突的存在并不预示术后视力不良。
