Study for Pathophysiology in Vitreo-retinal surgery

我们研究了玻璃体视网膜手术对视网膜功能和形态的影响。玻璃体切除术通过切除病变玻璃体和增生组织，是改善视网膜病理状况的有效治疗方法之一。然而，相反，手术本身可能对视网膜功能和/或视网膜循环产生不利影响。我们评估了在特发性黄斑孔手术中去除内限制膜对黄斑视网膜功能的影响，并得出结论，该手术对视力没有不良影响。然而，手术后FMERG b波恢复的选择性延迟表明黄斑区域视网膜生理学的改变（iovs2001）。我们进一步使用光学相干断层扫描对糖尿病性黄斑水肿患者的黄斑形态进行了评估，并在可见玻璃体牵引下得出结论，手术后黄斑结构恢复良好，尽管由于术前视网膜病理状况，视力恢复有限（AJO2001）。我们进一步研究了年龄相关性黄斑变性（AMD）在去除脉络膜新生血管和黄斑移位手术后的局部黄斑和全视野视网膜功能（IOVS2002）。这些研究表明黄斑功能的恢复与视网膜厚度的减少有关。黄斑移位手术是一种可行的技术，但术后视网膜总功能下降。在我们的另一项研究中，黄斑移位手术中获得的息肉样脉络膜血管病变的组织病理学与AMD的组织病理学相似（BJO2002）。

We studied the effects of vitreoretinal surgery on retinal function and morphology. Vitrectomy is one of the effective treatments for improvements of retinal pathological conditions by removing the diseased vitreous and proliferative tissues. Conversely, however, the procedure itself may give adverse effects on the retinal function and/or retinal circulation. We evaluated the effects of removal of internal limiting membrane on macular retinal function in idiopathic macular hole surgery by focal macular ERG (FMERG) and concluded that this procedure had no adverse effect on visual acuity. However, the selective delay of recovery of the FMERG b-wave after surgery suggests an alteration of retinal physiology in the macular region(IOVS200 1). We further evaluated the macular morphology using optical coherent tomography in diabetic macular edema with visible vitreous traction and concluded that the structure recovered well after surgery, although the recovery of visual acuity was limited because of their preoperative retinal pahological conditions(AJO2001). We further studied the local macular and full-field retinal functions of age related macular degeneration (AMD) after removal of choroidal neovascularization and macular translocation surgery, respectively(IOVS2002) (IOVS2002). These study demonstrated the recovery of macular function was contributed by the decreased retinal thickness. Macular translocation surgery may be well feasible technique, however, the total function of the retina was decreased after surgery. In our additional study, the histopathology of polypoidal choroidal vasculopathy obtained during macular translocation surgery demonstrated the similarity to those of the AMD(BJO2002).