Idiopathic vitreomacular traction and macular hole: a comprehensive review of pathophysiology, diagnosis, and treatment.
Idiopathic vitreomacular traction and macular hole: a comprehensive review of pathophysiology, diagnosis, and treatment.
复制标题
特发性玻璃体术和黄斑孔：对病理生理，诊断和治疗的全面综述。
DOI：
10.1038/eye.2013.212
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发表时间：
2013-10
期刊：
影响因子：
--
通讯作者：
Lotery AJ
中科院分区：
文献类型：
--
作者：
Steel DH;Lotery AJ
玻璃体后脱离(PVD)是老年眼的常见现象。然而，由于持续的症状性玻璃体黄斑粘连对黄斑施加牵引力(玻璃体黄斑牵引；VMT)，这可能会变得复杂。VMT本身可能与视网膜前膜的形成和特发性黄斑裂孔(IMH)的发展有关。这种病理可能会导致视觉障碍，包括视力变形、光视、视力模糊和视力下降，这些都会影响个人的生活质量。光学相干断层扫描等技术使黄斑解剖的可视化越来越准确，包括黄斑裂孔特征的量化，这有助于治疗决策。玻璃体切割术仍然是许多VMT或IMH患者的主要治疗选择；对于后者，与不剥离内界膜相比，剥离视网膜内界膜(ILM)显示出更好的结果。窄口径经结膜玻璃体切割术的发展提高了手术后的视力恢复率。通过降解玻璃体-视网膜交界处的层粘连蛋白和纤维连接蛋白，纤溶酶可以非侵入性的方式诱导PVD。事实上，临床研究已经支持在某些患者群体中将其用作手术的替代方案。然而，关于VMT和IMH发生的病理生理学基础的更多的了解，仍然需要进一步的研究。
Posterior vitreous detachment (PVD) is a common phenomenon in the aging eye. However, this may be complicated by persistent symptomatic vitreomacular adhesions that exert tractional forces on the macula (vitreomacular traction; VMT). VMT itself may be associated with epiretinal membrane formation and the development of idiopathic macular holes (IMH). Such pathologies may cause visual disturbances, including metamorphopsia, photopsia, blurred vision, and decreased visual acuity, which impact an individual's quality of life. Technologies such as optical coherence tomography allow an increasingly more accurate visualisation of the macular anatomy, including quantification of macular hole characteristics, and this facilitates treatment decision-making. Pars plana vitrectomy remains the primary treatment option for many patients with VMT or IMH; for the latter, peeling of the inner limiting membrane (ILM) of the retina has shown improved outcomes when compared with no ILM peeling. The development of narrow-gauge transconjunctival vitrectomy systems has improved the rate of visual recovery following surgery. Ocriplasmin, by degrading laminin and fibronectin at the vitreoretinal interface, may allow induction of PVD in a non-invasive manner. Indeed, clinical studies have supported its use as an alternative to surgery in certain patient populations. However, further research is still needed with respect to greater understanding of the pathophysiology underlying the development of VMT and IMH.
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影响因子：
13.7
作者：
de Smet, Marc D.;Gandorfer, Arnd;Kampik, Anselm
通讯作者：
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DOI：
10.1097/iae.0b013e318185fb5f
发表时间：
2008-09-01
影响因子：
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作者：
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影响因子：
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作者：
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影响因子：
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作者：
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