Hikichi T, Yoshida A, Trempe C L
Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
Am J Ophthalmol. 1995 Jan;119(1):55-61. doi: 10.1016/s0002-9394(14)73813-9.
Although the course of vitreomacular traction syndrome is necessary to treat patients or to establish the value of the surgical technique, little information is available about its course. In this study, we ascertained the natural history of vitreomacular traction syndrome.
We retrospectively studied 53 consecutive symptomatic eyes with vitreomacular traction syndrome.
In 43 (81%) of 53 eyes with cystoid macular changes at the diagnostic examination, 29 (67%) of 43 had cystoid changes that persisted during the median follow-up period of 60 months. The visual acuities at the time of the final examination decreased two Snellen lines or more from the initial measurement in 34 (64%) of 53 eyes. During the follow-up period, six (11%) of 53 eyes developed complete posterior vitreous detachment. The number of eyes with resolved cystoid changes or stable visual acuity was significantly higher when complete vitreomacular separation occurred (six of six) than when it did not (three [8%] of 37, P = .01; 13 [28%] of 47, P = .01).
Most symptomatic eyes with vitreomacular traction syndrome underwent a further decrease in visual acuity. Complete vitreomacular separation, which occurs infrequently in eyes with the disorder, allows resolution of cystoid changes and improvement of visual acuity.
尽管玻璃体黄斑牵引综合征的病程对于治疗患者或确立手术技术的价值而言是必要的，但关于其病程的信息却很少。在本研究中，我们确定了玻璃体黄斑牵引综合征的自然病史。
我们回顾性研究了53例连续的有症状的玻璃体黄斑牵引综合征患眼。
在诊断检查时53眼中有43眼（81%）存在黄斑囊样变性，在60个月的中位随访期内，43眼中有29眼（67%）囊样变性持续存在。在最后检查时，53眼中有34眼（64%）的视力较初始测量下降了两行或更多Snellen视力表行数。在随访期间，53眼中有6眼（11%）发生了完全性玻璃体后脱离。完全性玻璃体黄斑分离发生时，囊样变性消退或视力稳定的眼数（6眼中的6眼）显著高于未发生时（37眼中的3眼[8%]，P = 0.01；47眼中的13眼[28%]，P = 0.01）。
大多数有症状的玻璃体黄斑牵引综合征患眼视力进一步下降。完全性玻璃体黄斑分离在该疾病患眼中很少发生，它可使囊样变性消退并提高视力。
