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[孔源性视网膜脱离中玻璃体视网膜增殖的临床危险因素]

[Clinical risk factors of vitreoretinal proliferations in rhegmatogenous retinal detachment].

作者信息

Bonnet M

机构信息

Clinique Ophtalmologique Universitaire B, UFR Lyon-Nord, Hôpital de la Croix-Rousse, Lyon.

出版信息

J Fr Ophtalmol. 1994;17(8-9):530-40.

PMID:7989662
Abstract

PVR is a complication of rhegmatogenous retinal detachment which can occur only in predisposed eyes. Preoperative PVR and postoperative PVR can develop solely in retinal detachments associated with retinal breaks related to vitreous traction (horse-shoe tears, operculated tears, crescent tears and paravascular tears of the postequatorial region). PVR never develops in retinal detachments due to retinogenic retinal breaks (atrophic holes in lattice, and oral dialysis). There are 3 independent risk factors for postoperative PVR whose role has been demonstrated: preoperative PVR, horse-shoe tears extending on 90 degrees or more of the eye circumference, and horse-shoe tears with a curled and fixed posterior edge. The role of preoperative choroidal detachment as an independent risk factor, although likely, remains to be demonstrated. Cryotreatment is a risk factor for postoperative PVR solely in predisposed eyes. An alternative method to cryo should be used in high risk eyes.

摘要

增殖性玻璃体视网膜病变(PVR)是孔源性视网膜脱离的一种并发症,仅发生于易感眼。术前PVR和术后PVR仅在与玻璃体牵拉相关的视网膜裂孔(马蹄形裂孔、盖瓣裂孔、新月形裂孔和赤道后区域的血管旁裂孔)所致的视网膜脱离中出现。因视网膜源性视网膜裂孔(格子样萎缩孔和锯齿缘离断)导致的视网膜脱离不会发生PVR。术后PVR有3个已被证实起作用的独立危险因素:术前PVR、马蹄形裂孔在眼周延伸90度或以上、马蹄形裂孔伴有卷曲且固定的后缘。术前脉络膜脱离作为独立危险因素的作用虽有可能,但仍有待证实。冷冻治疗仅是易感眼术后PVR的一个危险因素。高危眼应采用冷冻治疗的替代方法。

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