平面旁玻璃体切除术后囊样黄斑水肿发生的影响因素:一项回顾性队列研究。

Reem H ElSheikh, Sairi Zhang, Muhammad Z Chauhan, Riley N Sanders, Sami H Uwaydat
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引用次数: 0

摘要

背景:在复杂的玻璃体视网膜手术中放置硅酮油后可能会出现囊样黄斑水肿(CME),导致视觉效果不佳。在这项研究中,我们调查了在玻璃体旁切除术(PPV)中使用硅酮油(SO)后发生 CME 的相关临床和手术特征:我们对 2010 年至 2020 年期间由一名外科医生在 PPV 手术中植入硅酮油的患者进行了回顾性病历审查。回顾了患者的人口统计学特征、眼油类型、眼油填塞持续时间、网膜切除大小、糖尿病状态、晶状体状态、之前的全视网膜光凝、视力和 CME 发生率:本研究共纳入了 40 名因视网膜脱离(RD)手术而接受 SO 填塞术的患者的 43 只眼睛。SO填塞的平均持续时间为(15.7 ± 12.7)个月(范围:1-58个月)。最常见的手术适应症是糖尿病牵引性视网膜脱离(32.7%),其次是外伤性视网膜脱离(16.3%)和伴有增殖性玻璃体视网膜病变的流变性视网膜脱离(11.6%)。在43只眼睛中,18只(41.9%)在植入SO的PPV术后首次出现CME,其中8只(44%)在去油后一年内缓解。发生 CME 的平均时间为 9 个月。逻辑回归模型显示,巩膜扣带手术和初始视力不佳是预测 CME 发生的重要统计学因素(ORs:分别为 11.65 和 16.06)。总体而言,91%的患者术后视力稳定或有所改善:使用巩膜扣手术和初始视力差是预测PPV手术硅油填塞后发生CME的重要因素,41.9%的患者发生了CME,平均持续时间为9个月。认识到这些因素可以及早监测并及时处理 CME:部分分析结果已在2020年ASRS会议上公布:临床试验编号:不适用。
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Factors affecting the development of cystoid macular edema following pars plana vitrectomy with silicone oil placement: a retrospective cohort study.

Background: Cystoid macular edema (CME) can develop following silicone oil placement in complex vitreoretinal surgeries, contributing to poor visual outcomes. In this study, we investigated the clinical and surgical characteristics associated with the development of CME following the use of silicone oil (SO) in pars plana vitrectomy (PPV) surgeries.

Methods: We conducted a retrospective chart review of patients who underwent implantation of SO during PPV from 2010 to 2020 by a single surgeon. Patient demographics, type of oil, duration of oil tamponade, retinectomy size, diabetic status, lens status, prior panretinal photocoagulation, visual acuity, and incidence of CME were reviewed.

Results: This study included 43 eyes from 40 patients who underwent SO tamponade for retinal detachment (RD) surgery. The mean duration of SO tamponade was 15.7 ± 12.7 months (range: 1-58 months). The most common indication for surgery was diabetic tractional RD (32.7%), followed by traumatic RD (16.3%) and rhegmatogenous RD with proliferative vitreoretinopathy (11.6%). Of the 43 eyes, 18 (41.9%) developed CME for the first time after PPV with SO placement, with 8 (44%) resolving within a year of oil removal. The mean duration for the development of CME was 9 months. A logistic regression model showed that a scleral buckle procedure and poor initial vision were statistically significant factors for predicting the development of CME (ORs: 11.65 and 16.06, respectively). Overall, 91% of the patients had stable or improved vision after surgery.

Conclusions: The use of a scleral buckle procedure and poor initial vision are significant factors for predicting CME following silicone oil tamponade in PPV surgeries, with 41.9% of patients developing CME with an average duration of 9 months. Recognizing such factors can lead to early monitoring and prompt management of CME.

Meeting presentation: Partial analyses were presented at the ASRS 2020 conference.

Clinical trial number: Not applicable.

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来源期刊
CiteScore
3.50
自引率
4.30%
发文量
81
审稿时长
19 weeks
期刊介绍: International Journal of Retina and Vitreous focuses on the ophthalmic subspecialty of vitreoretinal disorders. The journal presents original articles on new approaches to diagnosis, outcomes of clinical trials, innovations in pharmacological therapy and surgical techniques, as well as basic science advances that impact clinical practice. Topical areas include, but are not limited to: -Imaging of the retina, choroid and vitreous -Innovations in optical coherence tomography (OCT) -Small-gauge vitrectomy, retinal detachment, chromovitrectomy -Electroretinography (ERG), microperimetry, other functional tests -Intraocular tumors -Retinal pharmacotherapy & drug delivery -Diabetic retinopathy & other vascular diseases -Age-related macular degeneration (AMD) & other macular entities
期刊最新文献
Intravitreal faricimab for treatment naïve patients with neovascular age-related macular degeneration: a real-world prospective study. Retinal vascular changes after Silicon Oil removal in the Eye with Rhegmatogenous Retinal detachment. Short pulse grid and subthreshold micropulse laser (the sandwich grid) plus intravitreal ranibizumab for the treatment of diabetic macular edema. The digital age in retinal practice. Retrolental cohesive ophthalmic viscoelastic injection for severe subluxated cataracts: a prospective study.
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