自体视网膜神经上皮移植治疗复发性高度近视黄斑裂孔性视网膜脱离的疗效  

Efficacy of an Autologous Neurosensory Retinal Transplant for Recurrent Macular Hole Retinal Detachment in Highly Myopic Eyes

作　　者：李艳子 徐昶中 刘勇[1] 康雪琴 吴建华 Yanzi Li;Changzhong Xu;Yong Liu;Xueqin Kang;Jianhua Wu(Aier Eye Hospital of Wuhan University,Wuhan 430063,China)

机构地区：[1]武汉大学附属爱尔眼科医院,430063

出　　处：《中华眼视光学与视觉科学杂志》2020年第11期821-827,共7页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：武汉市卫健委医学科研项目(WX18B09)。

摘　　要：目的:观察自体视网膜神经上皮移植治疗复发性高度近视黄斑裂孔性视网膜脱离(MHRD)的临床疗效。方法:前瞻性临床研究。采用开放型质反应单向序贯试验方法,入选武汉大学附属爱尔眼科医院就诊的复发性高度近视MHRD患者7例(7眼),经自体视网膜神经上皮移植联合硅油填充术治疗,随访至硅油取出术后至少3个月,观察视网膜解剖复位、最佳矫正视力(BCVA)及术后并发症的发生情况,根据试验结果绘制序贯试验图。术前及末次随访时的BCVA比较采用配对t检验进行分析。结果:在视网膜解剖复位情况的观察中,试验至第7例时,试验线触及上界U,其中解剖复位成功6例,未成功1例,视网膜解剖复位率为86%。末次随访时所有患者BCVA(LogMAR)为1.35±0.34,与术前(2.06±0.33)比较,差异有统计学意义(t=5.977,P=0.001)。术后无一例出现玻璃体积血、视网膜切除部位增殖及裂孔开放、眼内炎等严重并发症,2例患者出现一过性眼压增高,予以局部降眼压药后,1周内眼压恢复正常。结论:自体视网膜神经上皮移植可有效治疗复发性高度近视MHRD,可明显提升该类患者的视力。Objective:To study the clinical effect of autologous neurosensory retinal transplants in the treatment of recurrent macular hole retinal detachment(MHRD)in highly myopic eyes.Methods:This was a prospective clinical study.An open qualitative response one-way sequential test method was used.Seven patients(7 eyes)with recurrent macular hole retinal detachment in highly myopic eyes were admitted to Aier Eye Hospital of Wuhan University,and underwent autologous neurosensory retinal transplantation combined with silicone oil tamponade.The follow-up period was at least 3 months after silicone oil removal.The main outcomes included retinal anatomical reattachment rate,best corrected visual acuity(BCVA)and postoperative complications.A sequential test diagram was plotted based on the test results.The pre-BCVA and post-BCVA were compared using a paired t-test.Results:Anatomical reattachment succeeded in 6 cases and failed in 1 case.The test line for the 7th case reached the upper boundary U.The retinal anatomical reattachment rate was 86%.At the last follow-up,the mean BCVA(1.35±0.34)logMAR was significantly improved over the pre-BCVA(2.06±0.33)logMAR(t=5.977,P=0.001).There were no serious complications such as vitreous hemorrhage,endophthalmitis,proliferation or the hole reopening at the retinal resection site.Two patients experienced transient intraocular hypertension,and intraocular pressure returned to normal within one week after antihypertensive drug treatment.Conclusions:Autologous neurosensory retinal transplants can treat recurrent MHRD effectively in highly myopic eyes and can significantly improve BCVA.

关 键 词：自体视网膜神经上皮移植 复发性视网膜脱离 高度近视 黄斑裂孔 

分 类 号：R779.6[医药卫生—眼科]