Internal limiting membrane peeling for decompression of macular edema in retinal vein occlusion: A report of 14 cases
Internal limiting membrane peeling for decompression of macular edema in retinal vein occlusion: A report of 14 cases
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DOI：
10.1097/00006982-200406000-00002
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发表时间：
2004-06-01
影响因子：
3.3
通讯作者：
Nrusimhadevara, RK
中科院分区：
文献类型：
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作者：
Mandelcorn, MS;Nrusimhadevara, RK
背景：目前，对于视网膜中央静脉阻塞（CRVO）引起的黄斑水肿尚无有效的治疗方法。此外，并非所有因视网膜分支静脉阻塞（BRVO）导致黄斑水肿的病例都对激光光凝有反应。我们推测，在视网膜静脉阻塞的情况下，通过内界膜（ILM）剥离来缓解黄斑水肿，将有利于血液和细胞外液从视网膜内层排出，从而减少黄斑水肿并改善视力。方法：连续 14 名因 CRVO 或选定的 BRVO 病例而出现黄斑水肿且不适合激光光凝的患者接受了平坦部玻璃体切除术，并切除了黄斑水肿。视网膜前玻璃体和 ILM 剥离用吲哚菁绿染料染色。结果：在所有病例中，视网膜内血液和视网膜增厚在手术后 6 周内减少。 78.6% 的病例视力得到改善。尽管一名患者术后 10 个月出现核性白内障，但没有发生手术并发症。结论：在这项非随机、非对照研究中，在选定的 CRVO 和 BRVO 病例中进行玻璃体切除术联合 ILM 剥离显示视力有所改善。这项试点研究进一步支持了这样的观点：与这些血管闭塞性疾病的自然史相比，ILM 剥离可能具有视觉益处。
Background: Currently, there is no proven treatment for macular edema due to central retinal vein occlusion (CRVO). Moreover, not all cases with macular edema due to branch retinal vein occlusion (BRVO) respond to laser photocoagulation. We postulated that internal limiting membrane (ILM) peeling for decompression of macular edema in cases of retinal vein occlusion would facilitate egress of blood and extracellular fluid out of the inner retinal layers, leading to reduction of macular edema and improvement in visual acuity.Methods: Fourteen consecutive patients with macular edema due to CRVO or selected cases of BRVO, not eligible for laser photocoagulation, underwent pars plana vitrectomy with removal of preretinal hyaloid and peeling of the ILM stained with indocyanine green dye.Results: In all cases, intraretinal blood and retinal thickening diminished within 6 weeks of surgery. Visual acuity improved in 78.6% of cases. No surgical complications occurred, although one patient developed nuclear cataract 10 months postoperatively.Conclusion: Pars plana vitrectomy with ILM peeling in selected cases of CRVO and BRVO showed improvement in visual acuity in this nonrandomized, noncontrolled study. This pilot study adds support to the concept that ILM peeling may of visual benefit when compared with the natural history in these vaso-occlusive diseases.