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视乳头切开术治疗视盘小凹性黄斑病变的长期预后

Karacorlu M, Sayman MI, Hocaoglu M, et al.

期刊名称:Retina

卷期:2016年第36卷第12期

摘要

目的:旨在评估视乳头切开术(RON)对视盘凹陷性黄斑病变患者中的长期疗效,并与颞侧单侧RON下玻璃体切除术(PPV)和无RONPPV的功能和解剖学预后进行比较。方法:这项回顾性研究包括连续15例视盘凹陷性黄斑病变手术治疗患者的15只眼。术后随访12-115个月。使用光学相干断层扫描,中央20°MP-1微量测定法来评估解剖学和功能预后,并检测最佳矫正视力。使用描述性统计方法,Friedman卡方检验,事后Dunn检验,Mann-Whitney检验,Wilcoxon符号秩检验和Fisher精确检验来确定时间点之间的最佳矫正视力和MP-1微观测量法之间的差异,并比较两个治疗组之间的结果。结果:平均年龄23.3±8.7(±标准误差)的2例男性和5例女性患者出现PPVRON硅油或气体栓塞。任何眼术后最佳矫正视力均未下降,6只眼(86%眼出现视力改善(3±2线)。术后6只眼(86%)中心黄斑积液完全消失。平均年龄28.2±8.2岁的5例男性和3例女性患者进行了PPV,出现后玻璃体脱离,伴有或不伴随乳头状激光治疗,以及硅油或气体填塞。手术后任何眼最佳矫正视力均未下降,5只眼(62.5%)视力改善(2±0.7线)。术后,4只眼(50%)中心黄斑积液眼中完全消失。结论:颞侧玻璃体切除术与,单一RON似乎是治疗视盘凹陷黄斑病变的一种有效方法。解剖和功能改善,随访期间没有额外的治疗或并发症,这表明RON可能是单独PPV治疗视盘凹陷性黄斑病变的一种替代治疗方法。

PURPOSE:To evaluate the long-term outcomes of radial optic neurotomy (RON) in patients with optic disk pit maculopathy and to compare the functional and anatomical outcomes of pars plana vitrectomy (PPV) with temporal side single RON versus PPV without RON.METHODS:This retrospective study included 15 eyes of 15 consecutive patients who had surgery for optic disk pit maculopathy. Patients were followed for 12 to 115 months after surgery. Anatomical and functional results were evaluated with optical coherence tomography, MP-1 microperimetry in the central 20°, and measurement of best-corrected visual acuity. Descriptive statistical methods, Friedman chi-square test, post hoc Dunn test, Mann-Whitney test, Wilcoxon signed-rank test, and Fisher's exact test were used to determine the best-corrected visual acuity and MP-1 microperimetry differences between time points and to compare the results between the two treatment groups.RESULTS:Two male and 5 female patients with a mean age 23.3 ± 8.7 (±standard error) years at presentation had PPV and silicone oil or gas tamponade with RON. Best-corrected visual acuity did not deteriorate after the operation in any of the eyes, and improved in 6 (86%) eyes (3 ± 2 lines). After surgery, complete resolution of fluid in the central macula was observed in 6 (86%) eyes. Five male and 3 female patients with a mean age 28.2 ± 8.2 years at presentation had PPV, posterior vitreous detachment, with or without juxtapapillary laser treatment, and silicone oil or gas tamponade. Best-corrected visual acuity did not deteriorate after the operation in any of the eyes, and improved in 5 (62.5%) eyes (2 ± 0.7 lines). After surgery, fluid in the central macula resolved completely in 4 (50%) eyes.CONCLUSION:Pars plana vitrectomy with temporal side, single RON seems to be an effective method of managing optic disk pit maculopathy. The anatomical and functional improvements, without additional treatment or complication during the follow-up period, indicate that RON might be an alternative treatment approach to PPV alone for optic disk pit maculopathy.


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