AIM: To observe the clinical effect of pars plana vitrectomy(PPV) and silicone oil filling surgery combined with intraoperative posterior scleral staphyloma(PS) marginal retinal photocoagulation in the treatment of hi...AIM: To observe the clinical effect of pars plana vitrectomy(PPV) and silicone oil filling surgery combined with intraoperative posterior scleral staphyloma(PS) marginal retinal photocoagulation in the treatment of high myopic macular hole retinal detachment(MHRD) with PS.METHODS: This was a retrospective clinical study. From May 2017 to March 2020, 62 MHRD patients with PS(62 eyes) were enrolled in the study. Patients were divided into 23 G PPV combined with PS marginal retina intraoperative photocoagulation group(combined group) and conventional surgery group(conventional group), with 31 eyes in each. Triamcinolone acetonide and indocyanine green were used to remove the epiretinal membrane and the posterior macular inner limiting membrane(ILM). In the combined group, 2 to 3 rows of retinal photocoagulation were performed on the edge of the PS. The patients were followed up for an average of 8.34±3.21 mo. The first retinal reattachment rate, macular hole closure rate, Duration of silicone oil tamponade, best corrected visual acuity(BCVA) and average number of operations were observed and compared between the two groups.RESULTS: The first retinal reattachment rates of the eyes in the combined group and the conventional group were 96.7%(29/31) and 67.7%(21/31), respectively(χ~2=6.613, P=0.010). The macular hole closure rates in the combined group and the conventional group were 74.2%(23/31) and 67.7%(21/31), respectively(χ~2=0.128, P=0.721). The Duration of silicone oil tamponade of the patients in the combined group was lower than that of the routine group(t=-41.962, P≤0.001). Postoperative log MAR BCVA values of patients in the combined group and the conventional group were 1.27±0.12 and 1.26±0.11, compared with the log MAR BCVA before surgery, each group was improved(t=19.947, t=-19.517, P≤0.001, P≤0.001). There was no significant difference in the log MAR BCVA between the eyes of the two groups(t=-0.394, P=0.695). The average numbers of operations on the eyes in the conventional group and the combined group were 2.39±0.62 and 2.06±0.25 times, the combined group had fewer operations on average(t=-2.705, P=0.009). CONCLUSION: Intraoperative PPV treatment of MHRD with PS combined with PS marginal endolaser photocoagulation can effectively increase the rate of retinal reattachment after the first operation, reduce the number of repeated operations, and reduce the postoperative duration of silicone oil tamponade.展开更多
Background It was well known that tangential vitreoretinal traction and epiretinal membrane play important roles during the formation of macular hole （MH） associated with retinal detachment （RD） in highly myopic e...Background It was well known that tangential vitreoretinal traction and epiretinal membrane play important roles during the formation of macular hole （MH） associated with retinal detachment （RD） in highly myopic eyes. But it was not clear about the correlations between anteroposterior traction, posterior vitreous cortex （PVC） and MH-RD. The vitreous status in highly myopic eyes were analyzed to explore the effect of PVC in the role of MH-RD formation. Methods Sixteen consecutive highly myopic eyes with RD due to MH were retrospectively analyzed from January 2009 to April 2009. The preoperative examinations for detecting posterior vitreous detachment （PVD） and vitreoretinal traction included B-mode ultrasonography and optical coherence tomography （OCT）. The residual PVC and PVD were confirmed intraoperatively during triamcinolone acetonide （TA） assisted vitrectomy. Results Under ultrasonography, the preoperative PVD patterns were stratified as： complete PVD in three （19%） eyes, partial PVD in eight （50%） eyes, and no PVD in five （31%） eyes. OCT confirmed vitreoretinal traction and no complete PVD in 10 （63%） eyes, including anteroposterior traction in four eyes and tangential traction in six eyes. During TA-assisted vitrectomy, it was confirmed that no complete PVD existed in 16 eyes, including six eyes （38%） finally diagnosed of partial PVD, and five （31%） eyes with vitreoschisis. Anteroposterior vitreoretinal traction around MH is always in conjunction with partial PVD （67%）, and high proportion （80%） of vitreoschisis is associated with tangential vitreoretinal traction. Comparing with the precision of TA staining of PVD diagnosis, the coincidence rate of ultrasonography was 69% （P=0.02）, and that of OCT was 63% （P 〈0.01）. Conclusions The residual PVC due to partial PVD or vitreoschisis may cause the anteroposterior or tangential traction of macular area, which contributes to the formation of MH and subsequent RD in highly myopic eyes. And it is necessary to realize the vitreoretinal relationship and assess the status of PVC synthetically for surgery by combined ultrasonography and OCT preoperatively and TA staining intraoperatively.展开更多
Purpose: To identify the pathologies of the vitreoretinal interface by Optical Coherence Tomography OCT of the retina in Lomé. Methodology: This is a retrospective analytical study, carried out in a specialized l...Purpose: To identify the pathologies of the vitreoretinal interface by Optical Coherence Tomography OCT of the retina in Lomé. Methodology: This is a retrospective analytical study, carried out in a specialized liberal center in Lomé. It was based on the analysis of OCT images of the retina, carried out with patients between October 2012 and October 2014. The variables collected were the socio-demographic characteristics, which were the various pathologies of the vitreoretinal interface. Results: 303 eyes of 164 patients were analyzed. The population was predominantly female (sex ratio = 0.95) aged 9 to 84 years with an average of 52.93 years. 121 eyes (39.9%) had posterior vitreous detachment with 66.1% in the 50 - 70 age group. 42 eyes (13.86%) presented vitreomacular traction with 66.6% in the 50 - 70 age group. 31 eyes (10.23%) presented an epi-retinal membrane with 61.2% in the 50 - 70 age group. 33 eyes (10.89%) had a full-thickness macular hole with 69.6% in the 50 - 70 age group. 4 eyes had a lamellar hole and 1 eye had a pseudo hole. Conclusion: OCT is an excellent tool for non-invasive exploration of the vitreoretinal interface. It gives precise information on the various pathologies of this interface. The need to evaluate the functional impact of these abnormalities, calls for other studies, especially prospective studies to assert their reality of those disease.展开更多
基金Supported by the Project of Integrated Traditional Chinese and Western Medicine by Tianjin Municipal Health Commission(No.2021067)。
文摘AIM: To observe the clinical effect of pars plana vitrectomy(PPV) and silicone oil filling surgery combined with intraoperative posterior scleral staphyloma(PS) marginal retinal photocoagulation in the treatment of high myopic macular hole retinal detachment(MHRD) with PS.METHODS: This was a retrospective clinical study. From May 2017 to March 2020, 62 MHRD patients with PS(62 eyes) were enrolled in the study. Patients were divided into 23 G PPV combined with PS marginal retina intraoperative photocoagulation group(combined group) and conventional surgery group(conventional group), with 31 eyes in each. Triamcinolone acetonide and indocyanine green were used to remove the epiretinal membrane and the posterior macular inner limiting membrane(ILM). In the combined group, 2 to 3 rows of retinal photocoagulation were performed on the edge of the PS. The patients were followed up for an average of 8.34±3.21 mo. The first retinal reattachment rate, macular hole closure rate, Duration of silicone oil tamponade, best corrected visual acuity(BCVA) and average number of operations were observed and compared between the two groups.RESULTS: The first retinal reattachment rates of the eyes in the combined group and the conventional group were 96.7%(29/31) and 67.7%(21/31), respectively(χ~2=6.613, P=0.010). The macular hole closure rates in the combined group and the conventional group were 74.2%(23/31) and 67.7%(21/31), respectively(χ~2=0.128, P=0.721). The Duration of silicone oil tamponade of the patients in the combined group was lower than that of the routine group(t=-41.962, P≤0.001). Postoperative log MAR BCVA values of patients in the combined group and the conventional group were 1.27±0.12 and 1.26±0.11, compared with the log MAR BCVA before surgery, each group was improved(t=19.947, t=-19.517, P≤0.001, P≤0.001). There was no significant difference in the log MAR BCVA between the eyes of the two groups(t=-0.394, P=0.695). The average numbers of operations on the eyes in the conventional group and the combined group were 2.39±0.62 and 2.06±0.25 times, the combined group had fewer operations on average(t=-2.705, P=0.009). CONCLUSION: Intraoperative PPV treatment of MHRD with PS combined with PS marginal endolaser photocoagulation can effectively increase the rate of retinal reattachment after the first operation, reduce the number of repeated operations, and reduce the postoperative duration of silicone oil tamponade.
文摘Background It was well known that tangential vitreoretinal traction and epiretinal membrane play important roles during the formation of macular hole （MH） associated with retinal detachment （RD） in highly myopic eyes. But it was not clear about the correlations between anteroposterior traction, posterior vitreous cortex （PVC） and MH-RD. The vitreous status in highly myopic eyes were analyzed to explore the effect of PVC in the role of MH-RD formation. Methods Sixteen consecutive highly myopic eyes with RD due to MH were retrospectively analyzed from January 2009 to April 2009. The preoperative examinations for detecting posterior vitreous detachment （PVD） and vitreoretinal traction included B-mode ultrasonography and optical coherence tomography （OCT）. The residual PVC and PVD were confirmed intraoperatively during triamcinolone acetonide （TA） assisted vitrectomy. Results Under ultrasonography, the preoperative PVD patterns were stratified as： complete PVD in three （19%） eyes, partial PVD in eight （50%） eyes, and no PVD in five （31%） eyes. OCT confirmed vitreoretinal traction and no complete PVD in 10 （63%） eyes, including anteroposterior traction in four eyes and tangential traction in six eyes. During TA-assisted vitrectomy, it was confirmed that no complete PVD existed in 16 eyes, including six eyes （38%） finally diagnosed of partial PVD, and five （31%） eyes with vitreoschisis. Anteroposterior vitreoretinal traction around MH is always in conjunction with partial PVD （67%）, and high proportion （80%） of vitreoschisis is associated with tangential vitreoretinal traction. Comparing with the precision of TA staining of PVD diagnosis, the coincidence rate of ultrasonography was 69% （P=0.02）, and that of OCT was 63% （P 〈0.01）. Conclusions The residual PVC due to partial PVD or vitreoschisis may cause the anteroposterior or tangential traction of macular area, which contributes to the formation of MH and subsequent RD in highly myopic eyes. And it is necessary to realize the vitreoretinal relationship and assess the status of PVC synthetically for surgery by combined ultrasonography and OCT preoperatively and TA staining intraoperatively.
文摘Purpose: To identify the pathologies of the vitreoretinal interface by Optical Coherence Tomography OCT of the retina in Lomé. Methodology: This is a retrospective analytical study, carried out in a specialized liberal center in Lomé. It was based on the analysis of OCT images of the retina, carried out with patients between October 2012 and October 2014. The variables collected were the socio-demographic characteristics, which were the various pathologies of the vitreoretinal interface. Results: 303 eyes of 164 patients were analyzed. The population was predominantly female (sex ratio = 0.95) aged 9 to 84 years with an average of 52.93 years. 121 eyes (39.9%) had posterior vitreous detachment with 66.1% in the 50 - 70 age group. 42 eyes (13.86%) presented vitreomacular traction with 66.6% in the 50 - 70 age group. 31 eyes (10.23%) presented an epi-retinal membrane with 61.2% in the 50 - 70 age group. 33 eyes (10.89%) had a full-thickness macular hole with 69.6% in the 50 - 70 age group. 4 eyes had a lamellar hole and 1 eye had a pseudo hole. Conclusion: OCT is an excellent tool for non-invasive exploration of the vitreoretinal interface. It gives precise information on the various pathologies of this interface. The need to evaluate the functional impact of these abnormalities, calls for other studies, especially prospective studies to assert their reality of those disease.
