Vitreous Detachment

玻璃体脱离
  • 文章类型: Journal Article
    这项研究的目的是评估高度近视患者的玻璃体后脱离(PVD)对视觉质量的影响,以及探讨高度近视患者明视和中视对比敏感功能(CSF)的相关因素。
    对高度近视患者的视觉质量进行综合评估。视敏度,对比敏感度(CS)在四个空间频率(3,6,12和18周期每度[c.p.d.])在明视和中视条件下,以及调制传递函数截止值(MTFcutoff),客观散射指数(OSI),斯特雷尔比率(SR),和内部像差,在这项横断面研究中进行了测量。
    这项研究包括47名双侧高度近视受试者的94只眼,包括23眼完全PVD(cPVD),21眼部分PVD(pPVD),50只眼无PVD(nPVD)。cPVD组与nPVD组视觉质量无显著差别。而在pPVD的眼中,总体明视CSF降解(与nPVD相比,P=0.048),在3c.p.d.(与cPVD,P=0.009和nPVD,P=0.032),在18c.p.d.(与nPVD,P=0.033),总体介孔CSF(与nPVD,P=0.033),和继发性散光(与cPVD,P=0.044)。在明视条件下,影响CSF的因素是pPVD和SR,而影响介孔CSF的因素是pPVD,OSI,神经节细胞内丛状层厚度。
    与nPVD或cPVD相比,高度近视患者的pPVD视觉质量受损,pPVD可能是在明视和中视照明下解释CSF的一个因素。
    由于视觉质量的潜在下降和玻璃体视网膜疾病的发展,临床医生需要密切监测患有pPVD的高度近视患者。
    UNASSIGNED: The purpose of this study was to evaluate the effects of posterior vitreous detachment (PVD) on visual quality in patients with high myopia, as well as investigate the associated factors of photopic and mesopic contrast sensitivity function (CSF) in high myopia.
    UNASSIGNED: Visual quality was comprehensively assessed in patients with high myopia. Visual acuity, contrast sensitivity (CS) at four spatial frequencies (3, 6, 12, and 18 cycles per degree [c.p.d.]) under photopic and mesopic conditions, as well as the modulation transfer function cutoff value (MTFcutoff), the objective scatter index (OSI), the Strehl ratio (SR), and internal aberrations, were measured in this cross-sectional study.
    UNASSIGNED: This study included 94 eyes from 47 subjects with bilateral high myopia, including 23 eyes with complete PVD (cPVD), 21 eyes with partial PVD (pPVD), and 50 eyes without PVD (nPVD). There was no significant difference in visual quality between the cPVD group and the nPVD group. Whereas in eyes with pPVD, there was a degradation of overall photopic CSF (versus nPVD, P = 0.048), photopic CS at 3 c.p.d. (versus cPVD, P = 0.009 and versus nPVD, P = 0.032), photopic CS at 18 c.p.d. (versus nPVD, P = 0.033), overall mesopic CSF (versus nPVD, P = 0.033), and secondary astigmatism (versus cPVD, P = 0.044). Under photopic conditions, the factors affecting CSF were pPVD and SR, whereas the factors affecting mesopic CSF were pPVD, OSI, and ganglion cell-inner plexiform layer thickness.
    UNASSIGNED: The pPVD impaired visual quality in patients with high myopia compared to nPVD or cPVD, and pPVD could be a factor explaining CSF at both photopic and mesopic illumination.
    UNASSIGNED: Clinicians need to closely monitor patients with high myopia with pPVD due to the potential decline in visual quality and the development of vitreoretinal disorders.
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  • 文章类型: Journal Article
    目的:探讨玻璃体黄斑牵引(VMT)患者术后视觉预后的预测因素。
    方法:这项回顾性研究纳入了29例特发性VMT患者的31只眼,这些患者接受了玻璃体切除术,随访时间≥3个月。根据光学相干断层扫描图像,将VMT分为三个等级:1级表示部分玻璃体黄斑分离并带有中央凹附着;2级表现为1级表现出视网膜内囊肿或裂隙;3级为2级加上视网膜下液。
    结果:三只眼睛在手术后出现了全层黄斑裂孔,均为3级患者.其余的28只眼睛,术后平均随访时间为23.3±25.8个月.术后中央凹厚度(P=0.001)和最终最佳矫正视力(BCVA;P<0.001)均较基线显着改善。15只眼睛(53.8%)增加了≥两条Snellen线。多元线性回归分析显示,基线BCVA越差(P=0.004),或VMT等级越先进(P=0.049),最后的BCVA越差。基线BCVA与术后视力改善呈负相关(P<0.001)。那些基线SnellenBCVA≥20/40的3级患者更有可能达到最终SnellenBCVA≥20/25(P=0.035)。
    结论:VMT分级是术后视觉预后的重要预测因素。对于3级患者,应尽早进行手术干预,以防止疾病进一步进展并最大程度地提高术后视觉效益。
    OBJECTIVE: To investigate the predictive factors for postsurgical visual prognosis in patients with vitreomacular traction (VMT).
    METHODS: This retrospective study enrolled 31 eyes from 29 patients who underwent vitrectomy for idiopathic VMT with a follow-up period of ≥3 months. The VMT was divided into three grades based on optical coherence tomography images: Grade 1 denoted partial vitreomacular separation with foveal attachment; Grade 2 exhibited intraretinal cysts or cleft with grade 1 findings; and Grade 3 was Grade 2 plus the subretinal fluid.
    RESULTS: Three eyes developed a full-thickness macular hole after surgery, all of which were Grade 3 patients. In the rest 28 eyes, the mean postoperative follow-up period was 23.3 ± 25.8 months. The postoperative central foveal thickness ( P = 0.001) and final best-corrected visual acuity (BCVA; P < 0.001) were both significantly improved from baseline. Fifteen eyes (53.8%) gained ≥ two Snellen lines. Multilinear regression analysis showed that the worse the baseline BCVA ( P = 0.004), or the more advanced the VMT grade ( P = 0.049), the worse the final BCVA. Baseline BCVA was negatively associated with the postoperative visual improvement ( P < 0.001). Those Grade 3 patients with baseline Snellen BCVA of ≥20/40 were more likely to achieve a final Snellen BCVA of ≥20/25 ( P = 0.035).
    CONCLUSIONS: The VMT grade is an important predictive factor for the postsurgical visual prognosis. Surgical intervention should be performed as early as possible for Grade 3 patients to prevent further disease progression and maximize the postsurgical visual benefit.
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  • 文章类型: Journal Article
    背景:为了研究Optos成像对视力退化性肌脱视(VDM)的诊断敏感性。
    方法:本横断面研究共收集了345例VDM患者的420只眼。所有眼睛都被分类为有玻璃体后脱离(PVD)或没有PVD。评估了Optos成像对玻璃体漂浮物可见性的敏感性。在单变量和多变量逻辑回归分析中,分析了与Optos图像上玻璃体漂浮物可见性的相关因素。
    结果:所有患者的平均年龄为56.19±13.89岁,66.67%的患者为女性。在所有眼睛的超声B扫描上都可以看到玻璃体漂浮物,但仅在47.62%的Optos图像中(有PVD的眼睛为55.29%,无PVD的眼睛为15%)。在多元二元逻辑回归分析中,年龄(OR=1.094,95CI=1.063-1.125,P<0.001),球形当量(OR=0.869,95CI=0.791-0.955,P=0.004)和漂浮物与视网膜的距离(OR=1.191,95CI=1.059-1.339,P=0.003)与玻璃体漂浮物在Optos图像上的可见度显着相关。在Optos图像上,25.71%的VDM眼表现出额外的视网膜异常。
    结论:Optos成像对玻璃体漂浮物的敏感性较低,特别是没有PVD的眼睛。在Optos成像上,漂浮物在老年患者中更明显,近视较大的眼睛,和离视网膜更远的漂浮物。
    BACKGROUND: To investigate the diagnostic sensitivity of Optos imaging for vision degrading myodesopsia (VDM).
    METHODS: A total of 420 eyes from 345 patients with VDM were collected in this cross-sectional study. All eyes were classified as having posterior vitreous detachment (PVD) or not having PVD. The sensitivity of Optos imaging for the visibility of vitreous floaters was evaluated. The associated factors with the visibility of vitreous floaters on Optos images were analyzed in univariate and multivariate logistic regression analyses.
    RESULTS: The mean age of all patients was 56.19 ± 13.89 years old, and 66.67% of patients were female. The vitreous floaters were visible on the ultrasound B scan in all eyes, but only in 47.62% of Optos images (55.29% in eyes with PVD and 15% in eyes without PVD). In the multiple binary logistic regression analysis, age (OR = 1.094, 95%CI = 1.063-1.125, P < 0.001), spherical equivalent (OR = 0.869, 95%CI = 0.791-0.955, P = 0.004) and the distance of the floaters from the retina (OR = 1.191, 95%CI = 1.059-1.339, P = 0.003) were significantly correlated with the visibility of vitreous floaters on Optos images. On Optos images, 25.71% of VDM eyes presented additional retinal abnormalities.
    CONCLUSIONS: Optos imaging has a low sensitivity for vitreous floaters, particularly in eyes without PVD. On Optos imaging, floaters were more visible in older patients, eyes with greater myopia, and floaters that were further from the retina.
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  • 文章类型: Journal Article
    目的:探讨玻璃体视网膜淋巴瘤(VRL)的B超特征。
    方法:单中心病例对照研究。
    方法:56例经活检证实的VRL患者共106只眼,纳入59例葡萄膜炎患者的86只眼。
    方法:对纳入眼进行B超检查。评估的是超声征象,以及一种称为离心冷凝的特殊模式,该模式是指超声检查中玻璃体雾度的外围超反射外观。
    方法:玻璃体后脱离(PVD),玻璃体视网膜粘连,玻璃体雾霾的位置,视网膜增厚或占位性病变,通过B超检查评估玻璃体雾霾的视网膜脱离和离心冷凝模式。比较两组之间这些体征的发生率;计算比值比(ORs)。
    结果:VRL患者(6/106)的玻璃体视网膜粘连发生率低于葡萄膜炎患者(20/86;P=0.001;OR=0.195,95CI:0.073-0.522)。VRL患者(21/106)视网膜增厚或占位病变的发生率高于葡萄膜炎患者(1/86;P=0.005;OR=19.068,95CI:2.455-148.265)。两组玻璃体后脱离和视网膜脱离的发生率差异无统计学意义(P=0.453和P=0.310)。VRL患者(49/106)比葡萄膜炎患者(13/86;P<0.001;OR=4.831,95CI:2.416-9.660)更有可能观察到离心冷凝模式。
    结论:B超可以帮助提供怀疑VRL的线索。视网膜增厚或占位性病变和玻璃体混浊的离心冷凝模式可能提示VRL。
    OBJECTIVE: To explore the characteristics of vitreoretinal lymphoma (VRL) in B-scan ultrasonography.
    METHODS: Single-center case-control study.
    METHODS: A total of 106 eyes of 56 patients with biopsy-proven VRL and 86 eyes of 59 patients with uveitis were included.
    METHODS: B-scan ultrasonography of the included eyes was performed. Evaluated were the ultrasonographic signs as well as a special pattern termed centrifugal condensation, which refers to the peripherally hyperreflective appearance of the vitreous haze in ultrasonography.
    METHODS: Posterior vitreous detachment, vitreoretinal adhesion, location of vitreous haze, thickening or occupying lesions of the retina, retinal detachment, and centrifugal condensation pattern of vitreous haze were evaluated through B-scan ultrasonography. The incidences of these signs were compared between the 2 groups; odds ratios (ORs) were calculated.
    RESULTS: The incidence of vitreoretinal adhesion in patients with VRL (6/106) was lower than in patients with uveitis (20/86; P = 0.001; OR: 0.195; 95% confidence interval [CI]: 0.073-0.522). The incidence of retinal thickening or occupying lesions in patients with VRL (21/106) was higher than that in patients with uveitis (1/86; P = 0.005; OR: 19.068; 95% CI: 2.455-148.265). The incidences of posterior vitreous detachment and retinal detachment were not significantly different between the 2 groups (P = 0.453 and P = 0.310, respectively). The centrifugal condensation pattern was more likely to be observed in patients with VRL (49/106) than in patients with uveitis (13/86; P < 0.001; OR: 4.831; 95% CI: 2.416-9.660).
    CONCLUSIONS: B-scan ultrasonography might help to provide clues for the suspicion of VRL. Thickening or occupying lesions of the retina and centrifugal condensation pattern of vitreous haze might be suggestive of VRL.
    BACKGROUND: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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  • 文章类型: Journal Article
    目的:通过比较非动脉炎性前部缺血性视神经病变(NAION)患者与正常人的玻璃体乳头界面特征,探讨玻璃体脱离在NAION发病机制中的作用。
    方法:本研究包括22例急性NAION患者(25只眼),21例非急性NAION患者(23只眼)和23例正常人(34只眼)。所有研究参与者都接受了扫频源光学相干断层扫描,以评估玻璃体乳头界面。乳头周围皱纹和乳头周围浅表血管突出。分析了乳头周围浅表血管突起测量值与NAION之间的统计相关性。两名NAION患者接受了标准的平坦部玻璃体切除术。
    结果:在所有急性NAION患者中均发现不完全乳头状玻璃体脱离。乳头周围皱纹的患病率为68%(17/25),30%(7/23)和0%(0/34),乳头状周围浅表血管突出的患病率为44%(11/25),91%(21/23)和0%(0/34)的急性,非急性NAION和对照组,分别。在没有视网膜神经纤维层变薄的眼睛中,乳头状周围浅表血管突出的患病率为88.9%。此外,NAION眼的上象限的乳头周围浅表血管突起的数量明显高于其他象限,与更受损的视野缺陷区域一致。两名NAION患者的乳头周围皱纹和视野缺损在玻璃体连接释放后1周和1个月内明显减弱,分别。
    结论:乳头周围皱纹和浅表血管突出可能是NAION患者乳头玻璃体脱离相关牵引的征象。乳头状玻璃体脱离可能在NAION的发病机制中起重要作用。
    OBJECTIVE: To evaluate the role of papillary vitreous detachment in the pathogenesis of non-arteritic anterior ischaemic optic neuropathy (NAION) by comparing the features of vitreopapillary interface between NAION patients and normal individuals.
    METHODS: This study included 22 acute NAION patients (25 eyes), 21 non-acute NAION patients (23 eyes) and 23 normal individuals (34 eyes). All study participants underwent swept-source optical coherence tomography to assess the vitreopapillary interface, peripapillary wrinkles and peripapillary superficial vessel protrusion. The statistical correlations between peripapillary superficial vessel protrusion measurements and NAION were analysed. Two NAION patients underwent standard pars plana vitrectomy.
    RESULTS: Incomplete papillary vitreous detachment was noted in all acute NAION patients. The prevalence of peripapillary wrinkles was 68% (17/25), 30% (7/23) and 0% (0/34), and the prevalence of peripapillary superficial vessel protrusion was 44% (11/25), 91% (21/23) and 0% (0/34) in the acute, non-acute NAION and control groups, respectively. The prevalence of peripapillary superficial vessel protrusion was 88.9% in the eyes without retinal nerve fibre layer thinning. Furthermore, the number of peripapillary superficial vessel protrusions in the superior quadrant was significantly higher than that in the other quadrants in eyes with NAION, consistent with the more damaged visual field defect regions. Peripapillary wrinkles and visual field defects in two patients with NAION were significantly attenuated within 1 week and 1 month after the release of vitreous connections, respectively.
    CONCLUSIONS: Peripapillary wrinkles and superficial vessel protrusion may be signs of papillary vitreous detachment-related traction in NAION. Papillary vitreous detachment may play an important role in NAION pathogenesis.
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  • 文章类型: Journal Article
    玻璃体牵引综合征是在部分玻璃体后脱离(PVD)的情况下由持续性玻璃体视网膜粘连引起的。玻璃体切除术和视网膜复位是一种有效的治疗方法。玻璃体皮质与视网膜内界膜(ILM)之间的粘连在青年时期更强,这给玻璃体切除术中诱导PVD带来了困难。一些临床研究表明,玻璃体切除术前玻璃体内注射纤溶酶可以降低脱离的风险。在我们的研究中,巴斯德毕赤酵母表达了一种新的重组人微纤溶酶原(rhμPlg)。分子对接显示rhμPlg与组织纤溶酶原激活物(t-PA)的结合与纤溶酶原相似,提示rhμPlg可以被t-PA激活以产生微纤溶酶(μPlm)。此外,rhμPlg在酰胺分解试验中具有比纤溶酶原更高的催化活性。通过眼内注射,在125μgrhμPlg处理的眼睛的玻璃体后极处发现了完整的PVD,而幼年兔的视网膜形态没有变化。我们的结果表明,rhμPlg在玻璃体视网膜病变的治疗中具有潜在的价值。
    Vitreomacular traction syndrome results from persistent vitreoretinal adhesions in the setting of partial posterior vitreous detachment (PVD). Vitrectomy and reattachment of retina is an effective therapeutic approach. The adhesion between vitreous cortex and internal limiting membrane (ILM) of the retina is stronger in youth, which brings difficulties to induce PVD in vitrectomy. Several clinical investigations demonstrated that intravitreous injection of plasmin before vitrectomy could reduce the risk of detachment. In our study, a novel recombinant human microplasminogen (rhμPlg) was expressed by Pichia pastoris. Molecular docking showed that the binding of rhμPlg with tissue plasminogen activator (t-PA) was similar to plasminogen, suggesting rh μPlg could be activated by t-PA to generate microplasmin (μPlm). Moreover, rhμPlg had higher catalytic activity than plasminogen in amidolytic assays. Complete PVD was found at vitreous posterior pole of 125 μg rhμPlg-treated eyes without morphological change of retina in juvenile rabbits via intraocular injection. Our results demonstrate that rhμPlg has a potential value in the treatment of vitreoretinopathy.
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  • 文章类型: Journal Article
    目的:确定白内障手术中玻璃体前脱离(AVD)和后牙材料的发生率,确定手术因素对它的影响,并确认材料的来源。
    方法:南通大学附属医院,江苏省,中国。
    方法:这是一个前瞻性的,单中心研究。
    方法:年龄,性别,眼睛状况,核硬化等级,超声波时间,平均纵向功率,累积耗散能量(CDE),总抽吸时间,并记录每位患者的估计液体使用情况.使用集成到显微镜中的实时光学相干断层扫描在手术之前和手术期间观察后解剖学。在用光纤照明期间仔细观察和记录具有AVD的眼睛。使用免疫组织化学将后牙材料染色。
    结果:本研究包括205例患者的205只眼。5例自发性AVD。术中,在115只眼中发现AVD(56.1%)。在75只眼中观察到后牙材料的存在(36.6%)。Logistic回归模型显示,CDE和误吸时间对AVD的影响有统计学意义(P<0.05,95%OR:1.011〜1.558;P<0.05,95%OR:1.026〜1.051)。CDE与后牙材料的发生呈正相关(P<0.05,95%OR:1.052~1.534)。来自五个病例的样品表达了大量的晶状体蛋白α和β蛋白。
    结论:自发性AVD在有晶状体眼很少见。手术期间AVD明显增加,超过三分之一的病例出现后牙材料。较高的CDE和较长的总误吸时间是AVD的危险因素。免疫组织化学显示,大多数后牙材料是晶状体碎片。
    To determine the incidence of anterior vitreous detachment (AVD) and retrolental material occurrence in cataract surgery, determine the influence of surgical factors on it, and confirm the source of the material.
    Affiliated Hospital of Nantong University, Jiangsu Province, China.
    Prospective single-center study.
    Age, sex, ocular complication, nuclear sclerosis grade, ultrasonic time, mean longitudinal power, cumulative dissipated energy (CDE), total aspiration time, and estimated fluid usage were recorded for each patient. Retrolental anatomy was observed before and during surgery using real-time optical coherence tomography integrated into a microscope. The eyes with AVD were carefully observed and recorded during illumination with an optical fiber. Retrolental material was stained using immunohistochemistry.
    205 eyes from 205 patients were included in this study. Spontaneous AVD was found in 5 cases. Intraoperatively, AVD was identified in 115 eyes (56.1%). Retrolental material presence was observed in 75 eyes (36.6%). A logistic regression model showed that CDE and aspiration time had a statistically significant effect on AVD ( P < .05, 95% CI, 1.011-1.558; P < .05, 95% CI, 1.026-1.051), and CDE was positively correlated with retrolental material occurrence ( P < .05, 95% CI, 1.052-1.534). Samples from 5 cases expressed large amounts of αA- and βA-crystallins.
    Spontaneous AVD is rare in phakic eyes. There was a marked increase in AVD during surgery, with retrolental material occurring in more than a third of cases. Higher CDE and longer total aspiration time were risk factors for AVD. Immunohistochemistry revealed that most of the retrolental materials were lens fragments.
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  • 文章类型: Journal Article
    目的:从玻璃体视网膜界面角度探讨玻璃体出血后玻璃体的变化及其预后。
    方法:对32只新西兰兔(64只眼)进行实验,体重2500-3000克4个月和无限性别,将0.2mL自体血注入玻璃体腔中心-研究组(右眼),和对照组以相同的方式用等体积的盐水处理。根据观察天数,将兔随机并等分为以下四批:注射后第3、7、14和30天。在行兔和眼球摘除前评估眼压和严重程度分级。分离眼前段自然流出玻璃体以检测液化程度和粘度。然后,电解质的化学成分,通过比色法和酶联免疫吸附测定(ELISA)测定PCT和bFGF。最后,玻璃体取样后观察到玻璃体后脱离(PVD)的发生率。这些研究是双盲的。
    结果:注射后,玻璃体混浊程度和凝块大小随时间减少。在不同的时间点,两组之间的液化程度和丝束长度均存在显着差异(均p<0.001)。从第14天开始,研究组的液化程度明显上升,粘度在初始时间显着下降。生化标志物暂时波动,除了碱性成纤维细胞生长因子(bFGF),继续上升,与液化程度相关(r=0.658,p<0.001)。此外,PVD的发生率从第14天开始增加(p<0.05),与巨噬细胞数量呈高度正相关(r=0.934;p<0.001)。
    结论:玻璃体出血后,玻璃体的变化较早(2-4周)相对较小,但后来不可逆转。具体来说,液化程度随着粘度的降低而增加,巨噬细胞和bFGF的趋化性诱导不完全的PVD。
    To explore the changes in vitreous body after vitreous hemorrhage and assess its prognosis from the perspective of vitreoretinal interface.
    The experiment was performed on 32 New Zealand rabbits (64 eyes), weighing 2500-3000 g for 4 months and unlimited gender, which was injected with 0.2 mL of autologous blood into the center of vitreous cavity-the study group (right eyes), and the control one was treated in the same manner with equal volumes of saline. The rabbits were randomly and equally divided into the following four batches according to the days of observation: Days 3, 7, 14, and 30 after injection. IOP and severity grading were evaluated before rabbits\' execution and eyeballs were enucleated. The anterior segment was separated to flow out the vitreous body naturally to detect the liquefaction degree and viscosity. Then, chemical composition of electrolytes, PCT and bFGF were determined by colorimetry and enzyme-linked immunosorbent assay (ELISA). Finally, the incidence of posterior vitreous detachment (PVD) was observed after vitreous sampled. The studies were double-blind.
    After injection, the extent of vitreous opacity and coagulum size decreased over time. Both the degree of liquefaction and the length of tow differed significantly between two groups at different time points (all p < 0.001). The liquefaction degree in the study group rose obviously from the Day 14, which the viscosity declined significantly on the initial time. Biochemical markers fluctuated temporarily, except for basic fibroblast growth factor (bFGF), which continued to rise and was correlated with the liquefaction degree (r = 0.658, p < 0.001). Besides, the incidence of PVD increased from the 14th day (p < 0.05), and it was highly positively correlated with the number of macrophages (r = 0.934; p < 0.001).
    After vitreous hemorrhage, the changes of the vitreous body are relatively minor earlier (2-4 weeks), but irreversible later. Specifically, the degree of liquefaction increases with a decrease in viscosity, and the chemotaxis of macrophages and bFGF induce incomplete PVD.
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  • 文章类型: Journal Article
    目的:本研究旨在观察长期随访中玻璃体后脱离(PVD)型视力下降肌营养不良(VDM)的自发缓解情况。
    方法:我们回顾性分析了拒绝任何治疗的PVD型VDM患者。描述了浮子症状发生的显着自发缓解的比例和时间。在单因素和多因素logistic回归分析中分析了漂浮物症状显着缓解的相关因素。
    结果:总计,对179例VDM患者进行了评估。所有患者的平均年龄为60.56±0.47岁,平均随访时间为23.89±6.63个月。在患者中,平均随访16.55±10.63个月后,有40.78%的漂浮物症状明显改善。近视(OR=0.280,95%CI=0.084-0.932,P=0.038),漂浮物数>3(OR=0.343,95%CI=0.172-0.683,P=0.002),在多元二元逻辑回归分析中,具有串状模式(OR=0.370,95%CI=0.166-0.824,P=0.015)和块状模式(OR=0.299,95%CI=0.090-0.993,P=0.049)的漂浮物与VDM症状的显着自发缓解呈负相关。
    结论:约40%的VDM伴PVD患者在长期随访期间可能经历显著的自发缓解。非近视性和较少漂浮物的患者更有可能感到VDM症状缓解。具有线状或块状图案的漂浮物不太可能自发缓解。
    OBJECTIVE: The study aims to observe the spontaneous remission of posterior vitreous detachment (PVD)-type vision degrading myodesopsia (VDM) during long-term follow-up.
    METHODS: We retrospectively reviewed VDM patients with PVD type that refused any treatment. The ratio and time of significant spontaneous remission of floater symptoms occurring were described. The associated factors with significant remission of floater symptoms were analyzed in the univariate and multivariate logistic regression analyses.
    RESULTS: In total, 179 patients with VDM were assessed. The mean age of all patients was 60.56 ± 0.47 years old, and the mean duration of follow-up was 23.89 ± 6.63 months. Of the patients, 40.78% have significant improvement in their floater symptoms after mean 16.55 ± 10.63-month follow-up. Myopia (OR = 0.280, 95% CI = 0.084-0.932, P = 0.038), the number of floaters > 3 (OR = 0.343, 95% CI = 0.172-0.683, P = 0.002), and floaters with string-like pattern (OR = 0.370, 95% CI = 0.166-0.824, P = 0.015) and blocky pattern (OR = 0.299, 95% CI = 0.090-0.993, P = 0.049) were negatively correlated with the significant spontaneous remission of VDM symptoms in the multiple binary logistic regression analysis.
    CONCLUSIONS: Approximately 40% of VDM patients with PVD may experience significant spontaneous remission during long-term follow-up. Patients that are non-myopic and with fewer floaters are more likely to feel relief from VDM symptoms. Floaters with string-like or blocky patterns are less likely to undergo spontaneous remission.
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  • 文章类型: Journal Article
    UNASSIGNED:本研究旨在通过与超场宽荧光素血管造影术(UWFFA)比较,评估宽视场扫描源光学相干断层扫描血管造影(WFSS-OCTA)在检测糖尿病性视网膜病变(DR)中的临床实用性,并研究全视网膜光凝(PRP)对玻璃体后脱离(PVD)状态的影响。
    UNASSIGNED:纳入最初接受PRP治疗的重度非增殖性DR(NPDR)或增殖性DR(PDR)患者。他们接受了WFSS-OCTA,在基线时进行了5次视觉固定的12×12-mm扫描,并在PRP治疗后进行了至少3个月的随访。没有禁忌症的患者在一周内接受UWFFA成像。使用两种方法对可见视野(FOV)区域的图像进行评估,非灌注面积(NPA),存在椎间盘新生血管形成(NVD),其他地方的新生血管形成(NVE),和PVD状态。
    未经批准:总共,分析了最初接受PRP治疗的28例DR患者的44只眼。UWFFA的FOV明显比WFSS-OCTA宽。NPA的定量测量在两种方法之间是一致的。在1只具有NPDR的眼睛(8.3%)和10只具有PDR的眼睛(47.8%)中,在全景OCTA成像区域之外检测到NPAs超过5DA。WFSS-OCTA对NVD和NVE的检出率高,假阳性率低。PRP治疗后,没有眼睛显示黄斑周围PVD阶段的进展,光盘,或在短期随访中的NVE。
    未经证实:WFSS-OCTA在临床上可用于评估DR中的NPAs和新生血管形成。PRP治疗在短期内不诱导PVD发展。
    This study aimed to assess the clinical usefulness of widefield swept source optical coherence tomography angiography (WF SS-OCTA) for detecting microvasculature lesions in diabetic retinopathy (DR) by comparing it with ultra-widefield fluorescein angiography (UWFFA) and to investigate the effect of panretinal photocoagulation (PRP) on posterior vitreous detachment (PVD) status.
    Patients with severe non-proliferative DR (NPDR) or proliferative DR (PDR) who were initially treated with PRP were enrolled. They underwent WF SS-OCTA with a 12×12-mm scan pattern of five visual fixations at baseline and at least a 3-month follow-up after PRP treatment. Patients with no contraindications underwent imaging with UWFFA within a week. Images were evaluated using two methods for the areas of the visible field of view (FOV), non-perfusion area (NPA), presence of neovascularization of the disc (NVD), neovascularization elsewhere (NVE), and PVD status.
    In total, 44 eyes of 28 patients with DR that were initially treated with PRP were analyzed. The FOV of the UWFFA was significantly wider than that of the WF SS-OCTA. The quantitative measurement of the NPAs was consistent between the two methods. NPAs more than 5DA outside the panoramic OCTA imaging area were detected in 1 eye with NPDR (8.3%) and in 10 eyes with PDR (47.8%). WF SS-OCTA had high detection rates for NVDs and NVEs, with a low rate of false positives. After PRP treatment, no eyes indicated progression in the PVD stages around the macula, optical disc, or NVEs at the short follow-up.
    WF SS-OCTA is clinically useful for evaluating NPAs and neovascularization in DR. PRP treatment does not induce PVD development in the short term.
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