孔源性视网膜脱离平坦部玻璃体切除术后视网膜移位

Amr Ali, Y. Serag, Hesham Eltoukhy, Raouf Gaber, Tamer Wasfy
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引用次数: 0

摘要

背景视网膜脱离(RD)手术成功后视网膜血管旁出现高荧光线的原因是视网膜移位的发生。这可能归因于一些患者在手术后出现的视功能异常。患者和方法进行前瞻性介入研究,包括30例原发性孔源性RD患者中的30眼,这些患者通过平坦部玻璃体切除术和硅油填塞成功地进行了RD手术。所有患者均进行了术前和术后眼底自发荧光和光学相干断层扫描。术后随访3个月,进行最佳矫正视力测试和Amsler网格测试。结果纳入组的平均年龄为53.7±9.2岁,17例(56.7%)患者为男性。最常见的撕裂部位是颞上区(43.3%),其次是多发性外周区(23.33%)、上鼻区(13.3%)、颞下区(133%),16眼(53.3%,95%置信区间:36.7–70.0%)。有视网膜移位的患者明显比没有视网膜移位的年轻(P=0.019)与移位的发生有关(P=0.028)。变形症在移位患者中明显更常见(P<0.001)。结论原发性孔源性视网膜病变修复成功后发生视网膜移位的可能性很高。年轻患者和增殖性玻璃体视网膜病变患者发生移位的风险更高。
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Retinal displacement following successful pars plana vitrectomy for rhegmatogenous retinal detachment
Background The appearance of hyperfluorescent lines next to the retinal blood vessels after successful retinal detachment (RD) surgery was explained by the occurrence of retinal displacement. This can attribute to the metamorphopsia experienced by some patients after their surgeries. Patients and methods A prospective interventional study was performed that included 30 eyes of 30 patients with primary rhegmatogenous RD, who had undergone successful RD surgery via pars plana vitrectomy and silicone oil tamponade. The entire patients had preoperative and postoperative fundus autofluorescence and optical coherence tomography. They were followed up for 3 months after surgery with testing of the best-corrected visual acuity and Amsler grid testing. Results The mean age of the included group was 53.7±9.2 years, and 17 (56.7%) patients were males. The most frequent tear site was upper temporal (43.3%), followed by multiple peripheral (23.33%), upper nasal (13.3%), lower temporal (13.3%), and the least was lower nasal (6.7%). Retinal displacement was detected by hyperfluorescent lines adjacent to the retinal blood vessels in the fundus autofluorescence imaging in 16 eyes (53.3% with 95% confidence interval: 36.7–70.0%). Patients with retinal displacement were significantly younger than patients without (P=0.019). The presence of proliferative vitreoretinopathy was significantly related to the occurrence of displacement (P=0.028). Metamorphopsia was significantly more frequent among patients with displacement (P<0.001). Conclusion Retinal displacement had a high possibility to occur after successful repair of primary rhegmatogenous RD. Young patients and patients with proliferative vitreoretinopathy are at a higher risk for displacement.
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