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慢性糖尿病拖拉性视网膜脱落和视觉敏度差:我们应该对这些患者进行手术吗?

Ryan B Rush^1,2,3,4, Sloan W Rush^1,2

¹Panhandle Eye Group, Amarillo, TX, USA.

Journal of vitreoretinal diseases

|August 11, 2025

概括

帕斯平面视膜切除术 (PPV) 在患有多发性糖尿病视网膜病变 (PDR) 和慢性黄斑引视网膜脱落 (TRD) 的患者中显著改善视力并减少不良事件. 降低PPV导致更糟糕的结果和严重视力丧失和并发症的风险更高.

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:

扩散性糖尿病视网膜病变 (PDR) 可能导致视力威胁的并发症,包括引视网膜脱落 (TRD).
患有视力敏度差 (VA) 的PDR患者的慢性斑点涉及TRD是一个重大管理挑战.
在这种特定的患者群体中,帕斯普拉纳视切除术 (PPV) 的疗效需要进一步评估.

研究的目的:

评估帕斯普拉纳视膜切除术 (PPV) 对患有慢性斑点性拖拉性视网膜脱落 (TRD) 的眼睛的视觉和安全益处,这是多发性糖尿病视网膜病变 (PDR) 的次要原因.
为了比较接受PPV和拒绝手术的患者之间的结果.

主要方法:

对175名患有PDR相关的斑点涉及TRD和手部运动或更严重的基线VA的患者进行了回顾性,病例控制的图表审查.
患者被分为一个研究组 (接受了PPV) 和一个控制组 (拒绝了PPV).
至少需要12个月的随访时间才能被纳入.

主要成果:

与对照组 (0.03 logMAR) 相比,PPV组显示视力敏度显著改善 (0.78 logMAR) (P < .0001).与对照组相比,PPV组显示视力敏度显著改善 (0.78 logMAR).
在PPV组中观察到达20/200或更好的和20/50或更好的Snellen VA的更高率.
对照组经历了显著更高的无光感知率,新血管性玻璃眼,和核化/内脏剥离.

结论:

帕斯平面玻璃切除术 (PPV) 对于患有PDR和慢性斑点涉及TRD的患者提供了有意义的视觉改善,即使基线视力差.
与手术干预的减少相比,PPV与较少的不良事件有关,包括严重的视力丧失和眼部发病率.
这些发现支持在PDR和慢性黄斑涉及TRD的选定患者中考虑PPV,以改善视觉结果并减少并发症.

关键词:

慢性拖拉性视网膜脱落视网膜脱落糖尿病的玻璃切除术视力敏度较差,视力敏度较差的人群.

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