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在患有增殖性糖尿病视网膜病变的患者体外切除术后糖尿病黄斑的变化

Han-Tao Zhou¹, Jing-Hao Mei¹, Ke Lin¹

¹National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.

International journal of ophthalmology

|May 19, 2025

概括

视切除术后的糖尿病黄斑 (PV-DME) 在增殖性糖尿病视网膜病变 (PDR) 患者中很常见. 更厚的手术前视网膜厚度和内部限制膜剥离增加风险,而三氨酸可以预防PV-DME.

科学领域:

眼科医生眼科眼科
视网膜疾病视网膜疾病
手术并发症手术并发症

背景情况:

糖尿病黄斑 (DME) 是增殖性糖尿病视网膜病变 (PDR) 的一个显著并发症.
玻璃切除术是PDR的常见手术,但它对DME的影响需要调查.
了解体外切除术后的DME (PV-DME) 对于管理PDR患者至关重要.

研究的目的:

为了研究PDR患者体内切除术后DME的发生率和变化.
确定与PV-DME发展相关的风险因素.
评估手术内干预对PV-DME的影响.

主要方法:

从330名接受玻璃切除术的PDR患者的365只眼睛的回顾性分析 (2018年1月-2022年3月).
光学连贯断层扫描 (OCT) 用于评估中枢视网膜厚度 (CRT) 和诊断PV-DME (CRT>300微米).
多变量回归分析 (Cox和线性) 用于识别风险因素和关联.

主要成果:

三个月后PV-DME的累积发病率为40.1%,主要是由于分散的视网膜加厚.
较厚的手术前CRT和手术内内部限制膜剥离是PV-DME的显著风险因素.
在外科手术期间注射的三氨醇乙化物证明了对PV-DME的保护作用.

结论:

对于PDR而言,PV-DME是PDR玻璃切除术后的常见并发症.
在外科手术期间,氨酸氨酸可以作为PV-DME的预防措施.
患有较厚的手术前CRT和接受内部限制膜剥离的患者需要在体外切除术后进行更密切的监测.

关键词:

糖尿病黄斑胀糖尿病黄斑胀增殖性糖尿病视网膜病变玻璃切除术 (vitrectomy) 是一种切除器官的方法.

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