Berger A S, Conway M, Del Priore L V, Walker R S, Pollack J S, Kaplan H J
Barnes Retina Institute, Washington University, St Louis, Mo., USA.
Arch Ophthalmol. 1997 Aug;115(8):991-6. doi: 10.1001/archopht.1997.01100160161004.
To determine the visual results, recurrence rates, and postoperative complications of surgical removal of subfoveal choroidal neovascularization (CNV) in patients with the presumed ocular histoplasmosis syndrome.
A consecutive surgical series of 63 eyes of 62 patients with subfoveal CNV and the presumed ocular histoplasmosis syndrome with longer than 6 months of follow-up.
Tertiary care university medical center.
Patients underwent surgical removal of subfoveal CNV using vitreoretinal surgical techniques. The anatomical and functional results of surgery were analyzed.
The median age of the patients was 42 years (range, 16-68 years), and the median follow-up time was 24 months (range, 6-48 months). Visual acuity improved by 2 or more Snellen lines in 22 (35%) of the 63 eyes, was unchanged in 28 (44%) of the eyes, and worsened in 13 (21%) of the eyes. Eleven (17%) of the 63 eyes improved to a visual acuity of 20/50 or better. Eyes with an initial visual acuity of 20/200 or worse had a better prognosis for improved vision (ie, 26 [41%] of the eyes) than those with an initial visual acuity of 20/100 or better (ie, 5 [8%] of the eyes). Recurrence of the subfoveal CNV occurred in 24 (38%) of the 63 eyes and was more common in those eyes that received preoperative laser photocoagulation (ie, 15 [47%] of the eyes). The median time to recurrence was 5 months after surgery. Post-operative complications included macular striae in 4 (6%) of the 63 eyes, rhegmatogenous retinal detachment in 2 (3%) of the eyes, retinal tear in 1 (1.6%) of the eyes, and progression of cataract in 19 (30%) of the eyes.
Surgical excision of subfoveal CNV may be an effective therapeutic modality in patients with the presumed ocular histoplasmosis syndrome that offers the possibility of improving central vision in many patients. Factors possibly associated with a favorable visual prognosis include younger patient age and the absence of previous laser photocoagulation.
确定疑似眼组织胞浆菌病综合征患者手术切除黄斑下脉络膜新生血管（CNV）后的视觉效果、复发率及术后并发症。
对62例患有黄斑下CNV且疑似眼组织胞浆菌病综合征的患者的63只眼进行连续手术系列研究，并进行超过6个月的随访。
三级医疗大学医学中心。
患者采用玻璃体视网膜手术技术进行黄斑下CNV手术切除。分析手术的解剖学和功能结果。
患者的中位年龄为42岁（范围16 - 68岁），中位随访时间为24个月（范围6 - 48个月）。63只眼中，22只眼（35%）的视力提高了2行或更多Snellen视力表行数，28只眼（44%）视力无变化，13只眼（21%）视力下降。63只眼中有11只眼（17%）视力提高到20/50或更好。初始视力为20/200或更差的眼比初始视力为20/100或更好的眼有更好的视力改善预后（即26只眼[41%]）。63只眼中有24只眼（38%）发生黄斑下CNV复发，且在接受术前激光光凝治疗的眼中更常见（即15只眼[47%]）。复发的中位时间为术后5个月。术后并发症包括63只眼中4只眼（6%）出现黄斑条纹，2只眼（3%）出现孔源性视网膜脱离，1只眼（1.6%）出现视网膜裂孔，19只眼（30%）出现白内障进展。
手术切除黄斑下CNV可能是疑似眼组织胞浆菌病综合征患者的一种有效治疗方式，可为许多患者提供改善中心视力的可能性。可能与良好视觉预后相关的因素包括患者年龄较轻和未进行过先前的激光光凝治疗。
