Macular changes after primary retinectomy for retinal detachment complicated by proliferative vitreoretinopathy.

Autor:	Grassi P; School of Medical Sciences, the University of Manchester, Manchester, UK., Charteris D; Vitreoretinal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Jazyk:	angličtina
Zdroj:	Clinical & experimental optometry [Clin Exp Optom] 2024 May; Vol. 107 (4), pp. 434-441. Date of Electronic Publication: 2023 Sep 06.
DOI:	10.1080/08164622.2023.2236098
Abstrakt:	Clinical Relevance: Primary retinectomy in eyes not previously vitrectomized has been previously rarely performed in a minority of cases, unlike non-primary retinectomies in vitrectomized eyes. Background: This paper aims to determine anatomical and functional outcomes of primary retinectomy, and to assess structural macular changes among successful cases. Methods: In this retrospective multicentre cohort-study, 35 primary retinectomies in eyes undergoing initial vitrectomy for rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy C or D between 2014 and 2021 were included. The mean follow-up duration was 48 ± 59.24 months among successes and 46.54 ± 20.99 months among unsuccesses (p = 0.483). Results: The anatomical success rate was 48.5% after one retinectomy and 60% after two retinectomies. Mean postoperative best corrected visual acuity (BCVA) was 1.85 ± 0.62 logMAR (6/425 Snellen equivalent). The difference from mean preoperative BCVA was not significant (p = 0.312). Final BCVA ≥ 6/60 was achieved in 17% of cases, and no cases gained ≥6/24. Final mean postoperative BCVA of successes was 1.69 ± 0.60 logMAR (6/294 Snellen equivalent) compared with 2.10 ± 0.57 logMAR (6/756 Snellen equivalent) of unsuccessful cases (p = 0.101). Post-operative macular optical coherence tomography was obtained from 95% of successes. Normal macular profile was found in 10% of cases, and the other cases demonstrated exudative maculopathy (60%), tractional maculopathy (20%) and macular atrophy (10%). Final BCVA was significantly higher in eyes with normal macular status compared to eyes with exudative maculopathy (p = 0.045) and macular atrophy (p = 0.025). Conclusion: Primary retinectomy may be used for rhegmatogenous retinal detachment complicated with advanced proliferative vitreoretinopathy. Anatomical and functional outcome were inferior than non-primary retinectomies for grade C proliferative vitreoretinopathy. Functional outcome was influenced by macular status. Positive prognostic factors include final anatomical success and normal final macular anatomy.
Databáze:	MEDLINE
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