Ohji M, Fujikado T, Saito Y, Hosohata J, Hayashi A, Tano Y
Department of Ophthalmology, Osaka University Medical School, Japan.
Semin Ophthalmol. 1998 Mar;13(1):52-62. doi: 10.3109/08820539809066082.
Subfoveal choroidal neovascular membrane is a leading cause of legal blindness. Photocoagulation has been effective, but photocoagulation of the fovea causes a decrease in vision immediately after treatment. Surgical removal of the choroidal neovascular membrane is effective for choroidal neovascular membrane in some cases, but it restores useful vision for reading (20/40 or better) in a small number of cases of choroidal neovascular membrane not due to presumed ocular histoplasmosis syndrome. A new treatment for subfoveal choroidal neovascular membrane, foveal translocation, is an innovative procedure in which the fovea is translocated onto healthier retinal pigment epithelium. Three techniques have been developed to relocate the retina, 2 of which (retinotomy and scleral shortening) we performed in 5 cases each. Preliminary results in these 10 cases indicate that foveal translocation provides improvement of visual acuity in 40% of eyes and final visual acuities useful for reading (better than 20/40) in 20% of eyes undergoing translocation with either technique. Further study is essential to refine the amount of translocation needed and to decrease complications of the 2 techniques, including retinal detachment, proliferative vitreoretinopathy, macular pucker, corneal astigmatism, and constricted visual field.
黄斑下脉络膜新生血管膜是导致法定失明的主要原因。光凝治疗有效，但黄斑光凝治疗后视力会立即下降。在某些情况下，手术切除脉络膜新生血管膜对脉络膜新生血管膜有效，但对于少数非疑似眼组织胞浆菌病综合征所致的脉络膜新生血管膜病例，手术仅能使少数患者恢复可用于阅读的有用视力（20/40或更好）。一种治疗黄斑下脉络膜新生血管膜的新方法——黄斑转位术，是一种将黄斑转位至更健康的视网膜色素上皮的创新手术。现已开发出三种视网膜复位技术，其中两种（视网膜切开术和巩膜缩短术）我们各实施了5例。这10例患者的初步结果表明，黄斑转位术可使40%的患眼视力提高，采用这两种技术进行转位的患眼中，有20%最终获得了可用于阅读的有用视力（优于20/40）。进一步的研究对于确定所需的转位量以及减少这两种技术的并发症（包括视网膜脱离、增殖性玻璃体视网膜病变、黄斑皱襞、角膜散光和视野缩小）至关重要。
