Treatment of Macular Detachment in Patients with Optic Pit
- il y a 12 ans
evrs.eu
Purpose:
To report the clinical outcome, of patients with congenital optic pit and macular retinal detachment, using vitrectomy, retinotomy and drainage of subretinal fluid with or without retinopexy or ILM peeling.
Methods:
17 consecutive patients with macular off retinal detachments and optic pit were enrolled in the study between 1985 and 2004. 10 were women 7 men with a mean age 39 years. The mean duration of the disease before surgery was 14 months. 8 patients underwent surgery including pars plana vitrectomy, fluid/expanding gas exchange (two eyes were filled with silicone oil) and laser pexy. 9 eyes had a vitrectomy in combination with retinotomy and internal drainage of subretinal fluid, fluid/expanding gas exchange but no retinopexy. Internal limiting membrane (ILM) was peeled off the detached macular region in seven eyes. Pre and postoperative best corrected visual acuity (BCVA); grade of retinal-macular reattachment (in 5 cases verified by OCT); postop cataract progression and cause of any reoperation were monitored.
Results:
The mean follow up was 33 months in the non retinopexy group and 97 months in the other group. The macula was attached at last visit in all cases in both groups. Visual field defects were described in 4 patients in the retinopexy group but none in the non retinopexy group.In the retinopexy group several reoperations were performed to achieve final result but in the non-retinopexy group no reoperations were needed.
Conclusion:
The traditional treatment with vitrectomy and retinopexy is reported with good anatomic result and some visual improvement although some patients complain of visual field disturbances. In our study reoperations were needed to achieve final reattachment of the macula using the standard technique. Cases treated without retinopexy however had good anatomical macular reattachment without reoperations and no visual field defects.
Take-home message:
Vitrectomy, ILM peeling, drainage of subretinal fluid and fluid/gas exchange without retinopexy, appears to give good anatomic results with few reoperations and no damage to the patients visual field.
Purpose:
To report the clinical outcome, of patients with congenital optic pit and macular retinal detachment, using vitrectomy, retinotomy and drainage of subretinal fluid with or without retinopexy or ILM peeling.
Methods:
17 consecutive patients with macular off retinal detachments and optic pit were enrolled in the study between 1985 and 2004. 10 were women 7 men with a mean age 39 years. The mean duration of the disease before surgery was 14 months. 8 patients underwent surgery including pars plana vitrectomy, fluid/expanding gas exchange (two eyes were filled with silicone oil) and laser pexy. 9 eyes had a vitrectomy in combination with retinotomy and internal drainage of subretinal fluid, fluid/expanding gas exchange but no retinopexy. Internal limiting membrane (ILM) was peeled off the detached macular region in seven eyes. Pre and postoperative best corrected visual acuity (BCVA); grade of retinal-macular reattachment (in 5 cases verified by OCT); postop cataract progression and cause of any reoperation were monitored.
Results:
The mean follow up was 33 months in the non retinopexy group and 97 months in the other group. The macula was attached at last visit in all cases in both groups. Visual field defects were described in 4 patients in the retinopexy group but none in the non retinopexy group.In the retinopexy group several reoperations were performed to achieve final result but in the non-retinopexy group no reoperations were needed.
Conclusion:
The traditional treatment with vitrectomy and retinopexy is reported with good anatomic result and some visual improvement although some patients complain of visual field disturbances. In our study reoperations were needed to achieve final reattachment of the macula using the standard technique. Cases treated without retinopexy however had good anatomical macular reattachment without reoperations and no visual field defects.
Take-home message:
Vitrectomy, ILM peeling, drainage of subretinal fluid and fluid/gas exchange without retinopexy, appears to give good anatomic results with few reoperations and no damage to the patients visual field.