Fibrovascular ingrowth at sclerotomy sites in vitrectomized diabetic eyes with recurrent vitreous hemorrhage - Ultrasound biomicroscopy findings
Fibrovascular ingrowth at sclerotomy sites in vitrectomized diabetic eyes with recurrent vitreous hemorrhage - Ultrasound biomicroscopy findings
复制标题
DOI：
10.1016/j.ophtha.2003.08.043
复制
发表时间：
2004-06-01
期刊：
影响因子：
13.7
通讯作者：
Krug, S
中科院分区：
文献类型：
--
作者：
Hershberger, VS;Augsburger, JJ;Krug, S
目的：探讨玻璃体术后玻璃体出血的糖尿病患者行超声生物显微镜（UBM）检查时，玻璃体切除眼巩膜切开处纤维血管向内生长（FVIG）的频率。设计：回顾性观察病例系列。研究对象：23例因增生性糖尿病视网膜病变（PDR）行玻璃体切除（PPV）术后复发性玻璃体出血的糖尿病患者，共26只眼。方法：超声生物显微镜下评价PDR PPV术后玻璃体出血或玻璃体不清的所有巩膜切开术部位。在进行玻璃体切除术翻修的眼睛中获得了与术中发现的相关性。8只眼在玻璃体切除术后再次行UBM，并评估先前巩膜切除术部位的变化。主要观察指标：各切开处超声生物显微镜图像分为无（0级）、轻微（1级）、严重（2级）3类。每个类别的UBM特征由审查员定义。进行Logistic回归分析以确定与研究患者FVIG发展相关的预后因素。结果：85%的病例检测到1级或2级FVIG， 58%的病例在大于或等于1级的巩膜切开术部位检测到2级FVIG。1级或2级FVIG在56%的微玻璃体部位、41%的输注部位和61%的轻端口部位检测到。10例患者因复发性不清玻璃体出血和UBM图像显示FVIG而接受重复玻璃体切除术。检查的硬膜切开术部位证实了UBM的发现在每一个病例。其中8例患者在重复玻璃体切除术后接受了UBM随访评估。8例患者中有6例随访UBM未见FVIG残留。结论：超声生物显微镜检查显示，在PDR PPV术后复发性玻璃体出血的眼睛中，FVIG的比例很高。超声生物显微镜能够检测和表征巩膜切开术部位的FVIG，并可能有助于再手术计划。(C) 2004年由美国眼科学会发布。
Purpose: To evaluate the frequency of fibrovascular ingrowth (FVIG) at sclerotomy sites in vitrectomized eyes of diabetic patients with postoperative vitreous hemorrhage referred for ultrasound biomicroscopy (UBM).Design: Retrospective observational case series.Participants: Twenty-six eyes of 23 diabetic patients with recurrent, nonclearing postoperative vitreous hemorrhage subsequent to pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR).Methods: Ultrasound biomicroscopy evaluation of all sclerotomy sites in patients referred for postoperative nonclearing or recurrent vitreous hemorrhage after PPV for PDR. Correlation with intraoperative findings was obtained in eyes undergoing revision of the vitrectomy. Eight eyes underwent repeat UBM after revision of the vitrectomy, and changes at previous sclerotomy sites were evaluated.Main Outcome Measures: Ultrasound biomicroscopy images at each sclerotomy site were classified into 3 categories: none (grade 0), minor (grade 1), and major (grade 2). The UBM characteristics of each category were defined by the examiner. Logistic regression analysis was performed to identify prognostic factors associated with development of FVIG in the study patients.Results: Grade 1 or 2 FVIG was detected in 85% of cases, and grade 2 FVIG was identified in greater than or equal to1 sclerotomy site in 58% of cases. Grade 1 or 2 FVIG was detected in 56% of microvitrector sites, 41% of infusion sites, and 61% of light port sites. Ten patients underwent repeat vitrectomy because of recurrent nonclearing vitreous hemorrhage and UBM images showing FVIG. Inspection of the sclerotomy site confirmed the UBM findings in every case. Eight of these patients underwent follow-up UBM evaluation subsequent to the repeat vitrectomy. In 6 of the 8 patients, follow-up UBM showed no residual FVIG.Conclusions: Ultrasound biomicroscopy showed FVIG in a high proportion of eyes that experienced recurrent nonclearing vitreous hemorrhage after PPV for PDR. Ultrasound biomicroscopy is capable of detecting and characterizing FVIG at sclerotomy sites and may aid in reoperative planning. (C) 2004 by the American Academy of Ophthalmology.