玻璃体手术治疗严重Valsalva视网膜病变的疗效观察

Clinical observation of vitrectomy for severe Valsalvaretinopathy

目的探讨Valsalva视网膜病变的病变特征,评价玻璃体切除联合内界膜剥除术治疗严重Valsalva视网膜病变的疗效。方法应用玻璃体切除术治疗严重Valsalva视网膜病变患者8例(8只眼),回顾分析Valsalva视网膜病变患者的临床特点。所有患者均行玻璃体切除联合内界膜剥除术,其中1只眼术中发生医源性视网膜裂孔,行视网膜激光光凝术后行硅油注入术。结果术后大部分患者玻璃体腔清晰。所有患者最终最佳矫正视力(BCVA)较术前均有4行以上的提高,术后1只眼裸眼视力1. 0,3只眼BCVA为0. 8,3只眼BCVA为0. 3～0. 6,1只眼BCVA为0. 3。本组病例最终随访未发现严重并发症。结论玻璃体切除联合内界膜剥除术是治疗严重Val-salva视网膜病变安全有效的方法之一,能迅速恢复患者的视力。

Objective To investigate the pathological features of Valsalva retinopathy and evaluate the efficacy of vitrectomy combined with inner limiting membrane (ILM) peeling in the treatment of severe Valsalva retinopathy. Methods 8 patients (8 eyes) of severe Valsalva retinopathy treated by vitrectomy. The clinical features of Valsalva retinopathy and the efficacy of treatment were retrospectively analyzed. All patients underwent vitrectomy combined with internal limiting membrane peeling, one of them had iatrogenic retinal tears during operation, and silicone oil injection was performed after retinal laser photocoagulation. Results Most patients have clear vitreous cavity after operation. The final BCVA of all patients was improved by more than 4 lines before surgery. The visual acuity of 1 eye was 1.0, BCVA of 3 eyes was 0.8, BCVA of 3 eyes was 0.3 ~ 0.6, and BCVA of 1 eye was 0.3. No serious complications were found during the final follow-up. Conclusion Vitrectomy combined with inner limiting membrane stripping is one of the safe and effective methods for the treatment of severe Valsalva retinopathy, which can quickly restore the patient's vision.