Retinal Displacement Toward Optic Disc After Internal Limiting Membrane Peeling for Idiopathic Macular Hole
Retinal Displacement Toward Optic Disc After Internal Limiting Membrane Peeling for Idiopathic Macular Hole
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DOI：
10.1016/j.ajo.2014.01.026
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发表时间：
2014-05-01
影响因子：
4.2
通讯作者：
Imamura, Yutaka
中科院分区：
文献类型：
--
作者：
Ishida, Masahiro;Ichikawa, Yoshikazu;Imamura, Yutaka
目得：检查视网膜移位后成功的黄斑裂孔（MH）手术与内界膜（ILM）剥离和气体填充，并确定之间的相关性位移的程度和基础MH size.DESIGN：回顾性，干预性，observational cases series.METHODS：连续患者的病历特发性MH进行玻璃体切除术与ILM剥离和气体填充进行了研究。术前（A）、术后2周、术后1、3、6、12个月（B），在眼底自体荧光或近红外图像上手动测量视盘与位于中央凹鼻侧或颞侧的2条视网膜血管交点之间的距离。在光谱域光学相干断层图像中测量MH的基底直径和最小直径。结果：21例患者（9例男性，平均年龄64.6 ± 8.4岁）21只眼，视网膜位移比值（A - B/A）与MHs基底直径之间的相关性进行了研究。10只眼（47.6%）为2期MH，9只眼（42.9%）为3期MH，2只眼（9.5%）为4期MH。术后2周时，颞侧视网膜血管向视盘移位260.8 ± 145.8 μ m，显著大于鼻侧视网膜血管的91.1 ± 89.7 μ m（配对t检验，P <0.001）。2周时颞区视网膜移位率与MH基底直径显著相关（斯皮尔曼等级相关系数=-0.476，P =.033）。术后颞侧视网膜向视盘的位移大于鼻侧视网膜，提示颞侧视网膜更有弹性，在MH时可向视盘回缩结束(C)2014年，Elsevier Inc. All rights reserved.
PURPOSE: To examine the retinal displacement following successful macular hole (MH) surgery with internal limiting membrane (ILM) peeling and gas tamponade, and to determine the correlation between the extent of displacement and the basal MH size.DESIGN: Retrospective, interventional, observational case series.METHODS: The medical records of consecutive patients with an idiopathic MH that had undergone vitrectomy with ILM peeling and gas tamponade were studied. The distances between the optic disc and the intersection of 2 retinal vessels located nasal or temporal to the fovea were measured manually preoperatively (A), and 2 weeks and 1, 3, 6, and 12 months postoperatively (B), on the fundus autofluorescence or near-infrared images. The basal and minimum diameters of the MHs were measured in the spectral-domain optical coherence tomographic images. The correlations between the ratio of the retinal displacement (A - B/A) and basal diameters of the MHs were determined.RESULTS: Twenty-one eyes of 21 patient's (9 men, mean age: 64.6 +/- 8.4 years) were studied. Ten eyes (47.6%) had stage 2 MH, 9 eyes (42.9%) had stage 3 MH, and 2 eyes (9.5%) had stage 4 MH. The temporal retinal vessels were displaced 260.8 +/- 145.8 mu m toward the optic disc at 2 weeks postoperatively, which was significantly greater than the 91.1 +/- 89.7 mu m of the nasal retinal vessels (paired t test, P < .001). The ratio of retinal displacement in the temporal field at 2 weeks was significantly correlated with the basal diameter of the MH (Spearman's rank correlation coeffieient = -0.476, P = .033.CONCLUSIONS: The greater displacement of the temporal retina than the nasal retina toward the optic disc postoperatively suggests that the temporal retina is more flexible and can be retracted toward the optic disc during the MH closure. (C) 2014 by Elsevier Inc. All rights reserved.