Paracentral retinal holes occurring after macular surgery: incidence, clinical features, and evolution
Paracentral retinal holes occurring after macular surgery: incidence, clinical features, and evolution
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DOI：
10.1007/s00417-012-1935-6
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发表时间：
2012-08-01
影响因子：
2.7
通讯作者：
Monin, Claire
中科院分区：
文献类型：
--
作者：
Sandali, Otman;El Sanharawi, Mohamed;Monin, Claire
描述黄斑手术后中央旁视网膜裂孔的发生率、临床特征和演变。一项回顾性非随机研究，纳入了2004年至2009年909例黄斑裂孔（MH，n = 400例患者）或视网膜前膜（ERM，n = 509例患者）。6例患者（0.6%）在手术后出现中心旁黄斑裂孔。他们的临床，自发荧光，光学相干断层扫描（OCT）的特点以及他们的视力结果进行了研究。患者的平均年龄为70岁。术后约5周（范围2-12周）出现中央旁裂孔。所有患者均无症状。5名患者在初次手术期间接受了ILM剥离。中央旁裂孔位于中央凹上方3例，颞侧3例。平均术前BCVA为20/200，平均术后BCVA为20/40。偏心MH最接近中央凹（低于1个视盘区域）的眼睛具有最差的最终视力。自体荧光成像显示黄斑旁孔中有明亮的荧光。在OCT图像上，它们显示为平坦的全层孔。未尝试治疗。所有患者均未发生孔源性并发症或脉络膜新生血管。平均随访2年。总之，中央旁多发性硬化是一种罕见的并发症，可能发生在ILM剥离开始或完成的部位。除了最接近中央凹的孔外，它们具有良好的视力预后，并且不需要任何治疗，这强调了尽可能从中央凹开始ILM剥离的重要性。
To describe the incidence, clinical features, and evolution of paracentral retinal holes occurring after macular surgery.A retrospective non-randomized study of 909 patients operated on for either a macular hole (MH, n = 400 patients) or an epiretinal membrane (ERM, n = 509 patients) between 2004 and 2009. Six patients (0.6%) developed a paracentral macular hole after surgery. Their clinical, auto-fluorescence, and optical coherence tomography (OCT) characteristics as well as their visual outcomes were studied.The mean age of patients was 70 years. Paracentral holes occurred approximately 5 weeks after surgery (with a range of 2-12 weeks). All patients were asymptomatic. Five patients underwent ILM peeling during initial surgery. Paracentral retinal holes were located superiorly to the fovea in three cases and temporally in the other three cases. Mean pre-operative BCVA was 20/200 and mean post-operative BCVA was 20/40. The eye where the eccentric MHs were closest to the fovea (inferior to 1 optic disc area) had the poorest final visual acuity. Autofluorescence imaging showed a bright fluorescence in paramacular holes. On OCT images, they were shown to be flat full-thickness holes. No treatment was attempted. No rhegmatogenous complications or choroidal neovascularization occurred in any of the patients. Mean follow-up was 2 years.In summary, paracentral MHs are uncommon complications which can occur at the site where ILM peeling has been initiated or completed. Except for the closest holes to fovea, they have good visual prognosis and do not require any treatment underlining the importance of initiating the ILM peeling as far as possible from the fovea.