Risk of progression in macula-on rhegmatogenous retinal detachment
Risk of progression in macula-on rhegmatogenous retinal detachment
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DOI：
10.1007/s00417-017-3696-8
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发表时间：
2017-08-01
影响因子：
2.7
通讯作者：
Feltgen, Nicolas
中科院分区：
文献类型：
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作者：
Callizo, Josep;Pfeiffer, Sebastian;Feltgen, Nicolas
目的明确可能导致黄斑部孔源性视网膜脱离(RRD)快速进展的因素，特别是可能导致黄斑病变的因素。研究对象包括2009至2013年间因伴有黄斑的原发孔源性视网膜脱离而接受手术治疗的患者。分析的相关因素包括年龄、手术延迟时间、晶状体状态、近视、脱离的位置和形态以及视网膜裂孔的数量、大小和类型。眼行光学相干断层扫描以检测黄斑脱离。结果共纳入116例(116只眼)视网膜脱离患者。入院至手术的平均延迟时间为1.8+/-1.4天。进展率为19.8%。其中47.8%表现为黄斑脱离。在黄斑病变进展的11只眼中，有10只眼(90.9%)也表现出大疱性结构，这是唯一与黄斑病变(p=0.0036)和无黄斑病变(p=0.0014)患者的视网膜脱离进展显著相关的参数。结论首次在前瞻性试验中，大疱性结构被发现是黄斑脱离进展的一个非常显著的预测因素。我们的数据支持诊断为大疱性黄斑部RRD的患者立即手术。
Purpose To identify factors that may lead to a rapid progression in macula-on rhegmatogenous retinal detachment (RRD), in particular, those that may lead to macular involvement.Methods Observational, prospective, single-center study. Patients referred for surgery due to primary rhegmatogenous retinal detachment with the macula on between 2009 and 2013 were included. Relevant factors analyzed included age, time delay until surgery, lens status, myopia, the detachment's location and configuration as well as number, size and type of retinal breaks. Eyes underwent optical coherence tomography to detect macular detachment. A multivariate analysis was performed to investigate the effect of several factors in the progression of retinal detachment.Results A total of 116 eyes of 116 patients were included. Mean time delay between admission and surgery was 1.8 +/- 1.4 days. Progression was observed in 19.8% of the eyes. Of those, 47.8% presented macular detachment. Ten of the 11 (90.9%) eyes presenting progression involving the macula also exhibited a bullous configuration, which was the only parameter that correlated significantly with detachment progression in patients with (p = 0.0036) and without (p = 0.0014) macular involvement.Conclusions For the first time in a prospective trial, a bullous configuration was found to be a highly significant predictor for progression in macula-on detachments. Our data support prompt surgery in patients diagnosed with bullous macula-on RRD.