Sato Y, Shimada H, Aso S, Matsui M
Department of Ophthalmology, Nihon University Surugadai Hospital, Tokyo, Japan.
Ophthalmology. 1994 Jan;101(1):63-7. doi: 10.1016/s0161-6420(94)31355-8.
The authors performed 15 vitrectomies for diabetic macular heterotopia, and then compared visual prognoses and postoperative complications with those of 88 macular detachments to determine the role of, and indications for, vitrectomy for diabetic macular heterotopia.
Fifteen patients with diabetic macular heterotopia and 88 with traction macular detachment, in which the vitreous cavities were sufficiently clear for posterior poles to be observed, underwent vitrectomies. Preoperative and postoperative visual acuity and postoperative complications were assessed and documented retrospectively.
There was no statistically significant difference between the two groups in terms of eyes showing improvement in visual acuity postoperatively. However, a final postoperative visual acuity better than 20/20 was documented in 93% of patients with macular heterotopia and 48% of patients with macular detachment (P < 0.002), whereas 47% of the former and 10% of the latter had visual acuities better than 20/40 (P < 0.001). Postoperative neovascular glaucoma and retinal detachment developed in 10% and 13%, respectively, of patients with macular detachments. None of the patients with macular heterotopia experienced these complications.
Based on the above results, the authors conclude that diabetic macular heterotopia is a very good indication for early vitrectomy.
作者对15例糖尿病性黄斑异位患者进行了玻璃体切除术，然后将其视力预后和术后并发症与88例黄斑脱离患者进行比较，以确定玻璃体切除术对糖尿病性黄斑异位的作用和适应证。
15例糖尿病性黄斑异位患者和88例牵引性黄斑脱离患者（玻璃体腔足够清晰，可观察到后极部）接受了玻璃体切除术。对术前和术后视力以及术后并发症进行回顾性评估和记录。
两组术后视力改善的眼睛在统计学上无显著差异。然而，黄斑异位患者中有93%、黄斑脱离患者中有48%的最终术后视力优于20/20（P<0.002），而前者有47%、后者有10%的视力优于20/40（P<0.001）。黄斑脱离患者中分别有10%和13%发生了术后新生血管性青光眼和视网膜脱离。黄斑异位患者均未出现这些并发症。
基于上述结果，作者得出结论，糖尿病性黄斑异位是早期玻璃体切除术的一个很好的适应证。
