与近视性黄斑裂孔自发改善相关的视网膜和玻璃体变化。

IF 5.9 Q1 OPHTHALMOLOGY Ophthalmology. Retina Pub Date : 2024-12-01 Epub Date: 2024-06-29 DOI:10.1016/j.oret.2024.06.017

Mathilde Goudot MD , Aude Couturier MD, PhD , William Beaumont MD , Alain Gaudric MD , Ramin Tadayoni MD, PhD , Elise Philippakis MD

{"title":"与近视性黄斑裂孔自发改善相关的视网膜和玻璃体变化。","authors":"Mathilde Goudot MD , Aude Couturier MD, PhD , William Beaumont MD , Alain Gaudric MD , Ramin Tadayoni MD, PhD , Elise Philippakis MD","doi":"10.1016/j.oret.2024.06.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the retinal and vitreous changes in eyes showing myopic macular schisis (MMS) improvement when vitrectomy was not performed and identify triggering factors.</div></div><div><h3>Design</h3><div>Retrospective observational study.</div></div><div><h3>Subjects</h3><div>Patients with nonoperated MMS.</div></div><div><h3>Methods</h3><div>The records of patients with MMS who were followed without performing surgery for >6 months were retrospectively reviewed, and the eyes showing an anatomic improvement were included. Myopic macular schisis evolution was analyzed quantitatively (central foveal thickness [CFT], parafoveal thickness, maximum height) and qualitatively (presence/absence of foveal detachment, lamellar hole, epiretinal membrane, choroidal neovascularization, inner and outer retinoschisis, vitreous status) at baseline and at the final visit. An anatomic improvement was defined as a decrease in CFT by ≥50 μm.</div></div><div><h3>Main Outcome Measures</h3><div>The rate of anatomic improvement of MMS without performing vitrectomy and the morphological changes observed in these cases.</div></div><div><h3>Results</h3><div>In a cohort of 74 nonoperated eyes with MMS, MMS improved in 14 eyes (19%) after a mean follow-up of 55 ± 38 months (range, 8–138). In these improved cases, the mean decrease in CFT was 153 ± 166 μm (range, 24–635; <em>P</em> = 0.005) and a complete resolution of MMS was observed in 9 eyes (64%). In 9 eyes (64%), the improvement was associated with visible vitreous changes in the macular area on the OCT scans. The mean visual acuity, which was already good at baseline (20/50, 0.4 ± 0.2 logarithm of the minimum angle of resolution), increased at the last visit (20/40, 0.3 ± 0.3 logarithm of the minimum angle of resolution) but without reaching significance.</div></div><div><h3>Conclusions</h3><div>This long-term follow-up analysis showed that almost 20% of MMS in eyes without indication for surgery could improve over time. In most cases, the improvement was associated with an apparent resolution of vitreous tensions.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"8 12","pages":"Pages 1192-1199"},"PeriodicalIF":5.9000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Retinal and Vitreous Changes Associated with Spontaneous Improvement in Myopic Macular Schisis\",\"authors\":\"Mathilde Goudot MD , Aude Couturier MD, PhD , William Beaumont MD , Alain Gaudric MD , Ramin Tadayoni MD, PhD , Elise Philippakis MD\",\"doi\":\"10.1016/j.oret.2024.06.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>To describe the retinal and vitreous changes in eyes showing myopic macular schisis (MMS) improvement when vitrectomy was not performed and identify triggering factors.</div></div><div><h3>Design</h3><div>Retrospective observational study.</div></div><div><h3>Subjects</h3><div>Patients with nonoperated MMS.</div></div><div><h3>Methods</h3><div>The records of patients with MMS who were followed without performing surgery for >6 months were retrospectively reviewed, and the eyes showing an anatomic improvement were included. Myopic macular schisis evolution was analyzed quantitatively (central foveal thickness [CFT], parafoveal thickness, maximum height) and qualitatively (presence/absence of foveal detachment, lamellar hole, epiretinal membrane, choroidal neovascularization, inner and outer retinoschisis, vitreous status) at baseline and at the final visit. An anatomic improvement was defined as a decrease in CFT by ≥50 μm.</div></div><div><h3>Main Outcome Measures</h3><div>The rate of anatomic improvement of MMS without performing vitrectomy and the morphological changes observed in these cases.</div></div><div><h3>Results</h3><div>In a cohort of 74 nonoperated eyes with MMS, MMS improved in 14 eyes (19%) after a mean follow-up of 55 ± 38 months (range, 8–138). In these improved cases, the mean decrease in CFT was 153 ± 166 μm (range, 24–635; <em>P</em> = 0.005) and a complete resolution of MMS was observed in 9 eyes (64%). In 9 eyes (64%), the improvement was associated with visible vitreous changes in the macular area on the OCT scans. The mean visual acuity, which was already good at baseline (20/50, 0.4 ± 0.2 logarithm of the minimum angle of resolution), increased at the last visit (20/40, 0.3 ± 0.3 logarithm of the minimum angle of resolution) but without reaching significance.</div></div><div><h3>Conclusions</h3><div>This long-term follow-up analysis showed that almost 20% of MMS in eyes without indication for surgery could improve over time. In most cases, the improvement was associated with an apparent resolution of vitreous tensions.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>\",\"PeriodicalId\":19501,\"journal\":{\"name\":\"Ophthalmology. Retina\",\"volume\":\"8 12\",\"pages\":\"Pages 1192-1199\"},\"PeriodicalIF\":5.9000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ophthalmology. Retina\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2468653024003105\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology. Retina","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468653024003105","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/29 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的：描述未进行玻璃体切割手术时近视性黄斑裂孔（MMS）得到改善的眼睛的视网膜和玻璃体变化，并确定诱发因素：设计：回顾性观察研究：方法：回顾性分析随访 6 个月以上未进行手术的近视性黄斑裂孔症患者的病历，并纳入出现解剖学改善的眼。在基线和最后一次就诊时，定量（中央眼窝厚度[CFT]、眼窝旁厚度、最大高度）和定性（有/无眼窝脱离、板层孔、视网膜外膜、脉络膜新生血管、内外视网膜裂孔、玻璃体状态）分析 MMS 的演变。主要结果指标：在不进行玻璃体切割的情况下，MMS的解剖学改善率以及在这些病例中观察到的形态学变化：结果：在74例未接受手术的MMS患者中，有14眼（19%）在平均随访55±38个月（范围：8-138）后MMS有所改善。在这些好转的病例中，CFT 的平均降幅为 153 ± 166 μm（范围：24-635，P=0.005），9 只眼睛（64%）的 MMS 完全消退。有 9 只眼睛（64%）的改善与 OCT 扫描中黄斑区可见的玻璃体变化有关。平均视力在基线时已经很好（20/50，0.4 ± 0.2 LogMAR），在最后一次就诊时有所提高（20/40，0.3 ± 0.3 LogMAR），但未达到显著水平：这项长期随访分析表明，近 20% 无手术指征的 MMS 患者的视力随着时间的推移会有所改善。在大多数情况下，这种改善与玻璃体张力的明显缓解有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

Retinal and Vitreous Changes Associated with Spontaneous Improvement in Myopic Macular Schisis

Purpose

To describe the retinal and vitreous changes in eyes showing myopic macular schisis (MMS) improvement when vitrectomy was not performed and identify triggering factors.

Design

Retrospective observational study.

Subjects

Patients with nonoperated MMS.

Methods

The records of patients with MMS who were followed without performing surgery for >6 months were retrospectively reviewed, and the eyes showing an anatomic improvement were included. Myopic macular schisis evolution was analyzed quantitatively (central foveal thickness [CFT], parafoveal thickness, maximum height) and qualitatively (presence/absence of foveal detachment, lamellar hole, epiretinal membrane, choroidal neovascularization, inner and outer retinoschisis, vitreous status) at baseline and at the final visit. An anatomic improvement was defined as a decrease in CFT by ≥50 μm.

Main Outcome Measures

The rate of anatomic improvement of MMS without performing vitrectomy and the morphological changes observed in these cases.

Results

In a cohort of 74 nonoperated eyes with MMS, MMS improved in 14 eyes (19%) after a mean follow-up of 55 ± 38 months (range, 8–138). In these improved cases, the mean decrease in CFT was 153 ± 166 μm (range, 24–635; P = 0.005) and a complete resolution of MMS was observed in 9 eyes (64%). In 9 eyes (64%), the improvement was associated with visible vitreous changes in the macular area on the OCT scans. The mean visual acuity, which was already good at baseline (20/50, 0.4 ± 0.2 logarithm of the minimum angle of resolution), increased at the last visit (20/40, 0.3 ± 0.3 logarithm of the minimum angle of resolution) but without reaching significance.

Conclusions

This long-term follow-up analysis showed that almost 20% of MMS in eyes without indication for surgery could improve over time. In most cases, the improvement was associated with an apparent resolution of vitreous tensions.