背景:本研究的目的是比较板层黄斑裂孔行玻璃体切割术患者与仅接受随访的患者的解剖和视觉变化。
方法:在这项回顾性连续病例系列研究中,我们评估了两组眼睛,包括19例层状黄斑裂孔患者的19只眼,这些患者接受了平坦部玻璃体切除术伴内界膜剥离,以及21例仅接受随访的层状黄斑裂孔患者的21只眼。校正后的远距视力(CDVA,在logmar中)和光学相干断层扫描结果,包括板层缺损的最大直径和中央凹厚度的测量,在初始和随访检查中记录了内节段/外节段带是否完整。
结果:在初次检查时,研究组平均CDVA为0.54logMAR,对照组为0.51logMAR,和0.33logMAR和0.55logMAR,分别,在期末考试。在研究小组中,发现10例患者(52.6%)术后光学相干断层扫描图像正常化,六个(31.5%),两者持平(10.5%),并且在干预组中进展为全厚度黄斑裂孔(5.2%),而对照组的所有患者在2004年3月至2010年6月的随访期内均出现恶化.
结论:在板层黄斑裂孔患者中,玻璃体切割和内界膜剥离联合治疗似乎是有效的,但对于治疗效果不佳的患者,需要进一步的研究来建立新的治疗模式.
BACKGROUND: The purpose of this
study was to compare anatomic and visual changes in patients with lamellar macular hole undergoing pars plana vitrectomy with those in patients undergoing follow-up only.
METHODS: In this retrospective consecutive case series
study, we evaluated two groups of eyes, comprising 19 eyes from 19 patients with lamellar macular hole who underwent pars plana vitrectomy with internal limiting membrane peeling and 21 eyes from 21 patients with lamellar macular hole who had follow-up only. Corrected distance visual acuity (CDVA, in logMAR) and optical coherence tomography findings, including measurements of maximum diameter of lamellar defect and foveal thickness, and whether the inner segment/outer segment band was intact or not were documented at initial and follow-up examinations.
RESULTS: At initial examination, mean CDVA was 0.54 logMAR in the
study group and 0.51 logMAR in the control group, and 0.33 logMAR and 0.55 logMAR, respectively, on final examination. In the
study group, postoperative optical coherence tomography images were found to be normalized in ten patients (52.6%), improved in six (31.5%), unchanged in two (10.5%), and to have progressed to full-thickness macular hole in one (5.2%) in the intervention group, while all patients in the control group were found to have deteriorated within the follow-up period between March 2004 and June 2010.
CONCLUSIONS: In patients with lamellar macular hole, combination treatment with pars plana vitrectomy and internal limiting membrane peeling appears to be effective, but further studies are required to establish new treatment modalities for patients who do not have a satisfactory outcome from treatment.