黄斑病变的玻璃体乳头粘连。

J Sebag, Michelle Y Wang, Dieuthu Nguyen, Alfredo A Sadun
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引用次数: 0

摘要

目的:玻璃体乳头状粘连(VPA)在黄斑病变中的作用尚不清楚。采用光谱域光学相干断层扫描/扫描激光检眼镜(SD-OCT/SLO)对黄斑孔洞、板层孔洞、黄斑皱褶和干性年龄相关性黄斑变性(AMD)的VPA进行鉴定。方法:对99例患者进行超声及SD-OCT/SLO检查,其中黄斑裂孔17例,板层裂孔11例,黄斑皱褶28例,干性AMD 15例,对照组28例。结果测量是超声检查是否存在完全后玻璃体脱离(PVD), SD-OCT/SLO检查是否存在VPA和视网膜内囊样间隙。结果:28只黄斑皱褶眼超声检出PVD 26例(92.9%),11只黄斑裂孔眼超声检出PVD 6例(54.5%)(P = 0.01), 17只黄斑裂孔眼超声检出PVD 4例(23.5%)(P = 0.000003)。SD-OCT/SLO在17只黄斑孔洞患者中检出15只(88.2%)VPA,在28只年龄匹配的对照组中检出11只(39.3%)(P = 0.002),在11只板层孔洞患者中检出4只(36.4%)(P = 0.01),在15只干性AMD患者中检出4只(26.7%)(P = 0.0008),在28只黄斑皱襞患者中检出5只(17.9%)(P = 0.000005)。15只伴有VPA的黄斑孔眼中有15只(100%)存在视网膜内囊样腔。有VPA的5只眼中有4只(80%)存在视网膜内腔隙,而无VPA的23只眼中只有1只(4.3%)存在视网膜内腔隙(P = 0.001)。结论:VPA在有黄斑裂孔的眼睛中比在有干性黄斑变性、板层裂孔或黄斑皱褶的眼睛中更常见。所有伴有VPA的黄斑孔眼均可见视网膜内囊样间隙。当出现在黄斑皱褶时,VPA通常与视网膜内囊样间隙有关。虽然这些研究没有直接研究因果关系,但VPA可能对玻璃体视网膜界面处的力矢量产生重要影响,从而产生囊状空隙和孔洞。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Vitreopapillary adhesion in macular diseases.

Vitreopapillary adhesion in macular diseases.

Vitreopapillary adhesion in macular diseases.

Vitreopapillary adhesion in macular diseases.

Purpose: The effect of vitreopapillary adhesion (VPA) in macular diseases is not understood. Spectral-domain optical coherence tomography/scanning laser ophthalmoscopy (SD-OCT/SLO) was used to identify VPA in macular holes, lamellar holes, macular pucker, and dry age-related macular degeneration (AMD).

Methods: Ultrasonography and SD-OCT/SLO were performed in 99 subjects: 17 with macular holes, 11 with lamellar holes, 28 with macular pucker, 15 with dry AMD, and 28 age-matched controls. Outcome measures were the presence of total posterior vitreous detachment (PVD) by ultrasound and the presence or absence of VPA and intraretinal cystoid spaces by SD-OCT/SLO.

Results: PVD was detected by ultrasound in 26 (92.9%) of 28 eyes with macular pucker, 6 (54.5%) of 11 eyes with lamellar holes (P = .01), and 4 (23.5%) of 17 eyes with macular holes (P = .000003). SD-OCT/SLO detected VPA in 15 (88.2%) of 17 eyes with macular holes, 11 (39.3%) of 28 age-matched controls (P = .002), 4 (36.4%) of 11 eyes with lamellar holes (P = .01), 4 (26.7%) of 15 eyes with dry AMD (P = .0008), and 5 (17.9%) of 28 eyes with macular pucker (P = .000005). Intraretinal cystoid spaces were present in 15 (100%) of 15 eyes with macular holes with VPA. In eyes with macular pucker, 4 (80%) of 5 with VPA had intraretinal cystoid spaces, but only 1 (4.3%) of 23 without VPA had intraretinal cystoid spaces (P = .001).

Conclusions: VPA was significantly more common in eyes with macular holes than in controls or eyes with dry AMD, lamellar holes, or macular pucker. Intraretinal cystoid spaces were found in all eyes with macular holes with VPA. When present in macular pucker, VPA was frequently associated with intraretinal cystoid spaces. Although these investigations do not study causation directly, VPA may have an important influence on the vectors of force at the vitreoretinal interface inducing cystoid spaces and holes.

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