长期存在的斑点-涉及糖尿病的拖拉性视网膜脱离,视觉敏度好:我们应该如何管理这些患者?
Ryan B Rush1,2,3,4, Sloan W Rush1,2
1Panhandle Eye Group, Amarillo, TX, USA.
Clinical ophthalmology (Auckland, N.Z.)
|January 17, 2024
概括
帕斯平面视切除术 (PPV) 可能会改善患有慢性拖拉性视网膜脱落 (TRD) 患者的视觉敏度,原因是多发性糖尿病视网膜病变 (PDR). 与延迟治疗相比,即时PPV显示显著视力增长的可能性更高.
科学领域:
- 眼科医生 眼科 眼科
- 视网膜外科手术 视网膜外科手术
- 糖尿病视网膜病变管理
背景情况:
- 在多发性糖尿病视网膜病变 (PDR) 中,慢性黄斑相关的拖拉性视网膜脱落 (TRD) 提出了手术挑战.
- 帕斯普拉纳视切除术 (PPV) 是用于视网膜脱落的常见手术.
研究的目的:
- 为了评估帕斯普拉纳视切除术 (PPV) 在患有良好的视力敏度和慢性斑点涉及PDR的二次TRD的患者中的疗效.
- 为了比较迅速的PPV和延迟治疗之间的结果.
主要方法:
- 对58名患有与PDR相关的斑点相关的TRD (>6个月持续时间) 和基线视力敏度 (VA) ≥20/50.的患者病历的回顾性审查.
- 患者被分为一个研究组 (即时PPV) 和一个控制组 (延期PPV).
- 最低随访时间为12个月,平均随访时间为27.6个月.
主要成果:
- 两组人都有类似的整体视力丧失 (-0.30 ±0.52 logMAR).
- 保持≥20/200和≥20/50VA的比率在即时PPV和延期治疗组之间是可比的.
- 提示PPV组显示,获得≥2条VA线的可能性显著更高 (p=0.002).
结论:
- 在患有良好的视觉敏度和慢性黄斑涉及拖拉性视网膜脱落 (TRD) 继发性多发性糖尿病视网膜病变 (PDR) 的患者中,即时的Pars plana vitrectomy (PPV) 与显著视觉改善的更大机会有关.
- 虽然整体视力损失可能类似,但早期手术干预似乎对一小部分患者有益.
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