Long-term follow-up of high myopic foveoschisis: Natural course and surgical outcome
Long-term follow-up of high myopic foveoschisis: Natural course and surgical outcome
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DOI：
10.1016/j.ajo.2006.10.053
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发表时间：
2007-03-01
影响因子：
4.2
通讯作者：
Gaudric, Alain
中科院分区：
文献类型：
--
作者：
Gaucher, David;Haouchine, Belkacem;Gaudric, Alain
中心点 目的：确定近视性黄斑中心凹劈裂 (MF) 的自然演变和手术指征（目前尚缺乏记录），以及预测不良预后的因素。中心点设计：回顾性观察病例系列。中心点方法：对 29 例手术和未手术的 MF 病例（23 名患者的 29 只眼睛）进行了研究。在平均 31.2 个月的随访期间，所有眼睛都接受了重复检查，包括光学相干断层扫描 (OCT) 记录。特别关注视力（VA）的演变和中央凹的厚度。中心点结果：平均屈光度为-14.4屈光度，平均眼轴长度为29.1毫米。 OCT 扫描显示，黄斑中心凹劈裂与黄斑异常相关：29 只眼中的 13 只眼（44.8%）存在黄斑前结构，29 只眼中的 10 只眼（34.5%）存在黄斑中心凹脱离，29 只眼中的 6 只眼（20.7%）存在板层黄斑裂孔。四只眼（13.8%）发现孤立性中央凹劈裂。在随访过程中，20 只眼的中心凹劈裂和 VA 恶化，9 只眼保持稳定。恶化的 20 只眼睛中有 10 只存在黄斑前结构。九只眼睛出现黄斑裂孔，其中六只眼睛此前曾出现黄斑中心凹脱离。 11 只患有黄斑劈裂的眼睛接受了手术，显着改善了 VA（P = .04，Wilcoxon 检验），但 3 只眼睛出现了黄斑裂孔。中心点结论：MF 可能会保持稳定多年，而不影响 VA。然而，当它与黄斑前结构的存在相结合时，视力下降的风险就会增加。当它与黄斑中心凹脱离相结合时，无论是否进行手术，黄斑裂孔似乎都会频繁出现。
center dot PURPOSE: To determine the natural evolution and surgical indications of myopic foveoschisis (MF), which are still poorly documented, and the factors that predict poor prognosis.center dot DESIGN: Retrospective observational case series.center dot METHODS: Twenty-nine operated and nonoperated cases of MF (29 eyes of 23 patients) were studied. All eyes underwent repeated examinations, including optical coherence tomographic (OCT) recordings, during a mean follow-up of 31.2 months. Special attention was paid to the evolution of visual acuity (VA) and to the thickness of foveoschisis.center dot RESULTS: Mean refraction was -14.4 diopters, and mean axial length was 29.1 mm. OCT scans revealed that the foveoschisis was associated with macular anomalies: a premacular structure in 13 (44.8%) of 29 eyes, a foveal detachment in 10 (34.5%) of 29 eyes, and a lamellar macular hole in six (20.7%) of 29 eyes. Isolated foveoschisis was found in four eyes (13.8%). During follow, up, foveoschisis and VA worsened in 20 eyes and remained stable in nine. Ten of the 20 eyes that worsened had a premacular structure. A macular hole occurred in nine eyes, six of which had previously exhibited foveal detachment. Eleven eyes with foveoschisis underwent surgery, which improved VA significantly (P = .04, Wilcoxon test), but three eyes developed a macular hole.center dot CONCLUSIONS: MF may remain stable for many years without affecting VA. However, when it is combined with the presence of a premacular structure, the risk of a decrease in VA increases. When it is combined with foveal detachment, a macular hole seems to develop frequently, whether or not surgery is performed.