目的:在一组被诊断为牵牛花综合征(MGS)的儿科患者中,确定单独的预防性近顶激光光凝治疗预防视网膜脱离(RD)的解剖和视觉结果。
方法:对22例年龄0-15岁的MGS患者的24只眼进行了回顾性分析。数据包括人口统计,眼部检查,解剖和视觉结果,收集治疗后的并发症。
结果:2例患者接受了双侧激光治疗,20例患者接受了单眼激光治疗。13例(59.1%)患者的治疗年龄小于12mo。表现症状包括斜视(6/22,27.3%),视力下降(2/22,9.1%),和常规眼底筛查(14/22,63.6%)。15例(68.2%)患者接受了头颅磁共振成像(MRI)检查,15人中有3人(20.0%)在神经系统中发现异常。基于术前宽视野眼底摄影和B超回波描记术,所有(100.0%)眼无明显RD。术后1mo和6mo及以下随访,所有眼睛的解剖结果保持稳定。平均随访时间为27.7±17.5mo。未发现严重并发症。2例(9.1%)患者的术前视力从光感知到20/200不等。11例(50.0%)患者的术后视力从光感知到20/125不等。
结论:在短期随访中,儿童MGS患者单纯预防性近顶激光治疗的初步解剖和视觉结果相对稳定。需要进一步的长期临床观察以确认其有效性和安全性。
OBJECTIVE: To determine the anatomic and visual outcomes of prophylactic juxtapapillary laser photocoagulation treatment alone in the prevention of retinal detachment (RD) in a cohort of pediatric patients diagnosed with morning glory syndrome (MGS).
METHODS: A total of 24 eyes of 22 consecutive patients aged 0-15y diagnosed with MGS treated with prophylactic juxtapapillary laser photocoagulation alone were reviewed. Data including demographics, ocular examination, anatomic and visual outcomes, following treatment and complications were collected.
RESULTS: Two patients had bilateral laser treatment and 20 had monocular laser treatment. The age at treatment of 13 (59.1%) patients was less than 12mo. The presenting symptoms included strabismus (6/22, 27.3%), decreased vision (2/22, 9.1%), and routine fundus screening (14/22, 63.6%). Fifteen (68.2%) patients underwent cranial magnetic resonance imaging (MRI) examinations, and 3 of those 15 (20.0%) had abnormal findings in the nervous system. Based on preoperative wide-field fundus photography and B-scan echography, all (100.0%) eyes had no obvious RD. On postoperative 1mo and 6mo and the following follow-ups, the anatomic outcomes of all eyes remained stable. The mean follow-up duration was 27.7±17.5mo. No severe complications were found. Preoperative visual acuity acquired from 2 (9.1%) patients ranged from light perception to 20/200. Postoperative acuity acquired from 11 (50.0%) patients ranged from light perception to 20/125.
CONCLUSIONS: The preliminary anatomic and visual outcomes of prophylactic juxtapapillary laser treatment alone in pediatric MGS patients are relatively stable in a short-term follow-up. Further long-term clinical observation will be needed to confirm its efficacy and safety.