CAJ | 학술논문

目的探讨伴有脉络膜脱离的黄斑裂孔性视网膜脱离术前皮质类固醇激素的应用价值.方法对确诊为伴有脉络膜脱离的黄斑裂孔性视网膜脱离68例(68只眼),分为术前激素治疗组29例(29只眼),按激素禁忌与否给予地塞米松15mg静脉滴注和(或)1%泼尼松龙滴眼液.另一组39例(39只眼)在术前不给予激素治疗.在玻璃体手术后比较二组一次性视网膜解剖复位率、视力和视网膜脱离再发情况.结果 29只眼激素治疗后1周内62%脉络膜脱离复位,脉络膜脱离复位与否玻璃体手术一次性解剖复位率分别为83.3%与90.7%,二者对比差异无统计学意义(P>0.05).激素治疗组与直接手术组一次性视网膜脱离解剖复位率为86.2%、89.7%,二者差异也无统计学意义(P>0.05).视力预后二者视力提高者直接手术组略高于激素治疗组,视网膜脱离复发率二组相当.结论对于伴有脉络膜脱离的黄斑裂孔性视网膜脱离,及早手术是决定预后的关键,脉络膜脱离存在与否对视网膜脱离复位及视力无明显影响,术前皮质类固醇激素的应用无重要意义.
목적 탐토반유맥락막탈리적황반렬공성시망막탈리술전피질류고순격소적응용개치.방법 대학진위반유맥락막탈리적황반렬공성시망막탈리68례(68지안),분위술전격소치료조29례(29지안),안격소금기여부급여지새미송15mg정맥적주화(혹)1%발니송룡적안액.령일조39례(39지안)재술전불급여격소치료.재파리체수술후비교이조일차성시망막해부복위솔、시력화시망막탈리재발정황.결과 29지안격소치료후1주내62%맥락막탈리복위,맥락막탈리복위여부파리체수술일차성해부복위솔분별위83.3%여90.7%,이자대비차이무통계학의의(P>0.05).격소치료조여직접수술조일차성시망막탈리해부복위솔위86.2%、89.7%,이자차이야무통계학의의(P>0.05).시력예후이자시력제고자직접수술조략고우격소치료조,시망막탈리복발솔이조상당.결론 대우반유맥락막탈리적황반렬공성시망막탈리,급조수술시결정예후적관건,맥락막탈리존재여부대시망막탈리복위급시력무명현영향,술전피질류고순격소적응용무중요의의.
Objective To evaluate the efficacy of corticosteroid administration prior to vitrectomy for macular rhegmatogenous retinal detachment with choroidal detachment.Methods Of 68 cases of macular rhegmatogenous retinal detachment with choroidal detachment,29 cases (Group A)received intensive 1% pre-dinisolone acetate eye drops or intravenous injection of 15 mg Dexamethasone or both above,and 39 cases (Group B)received pars plana vitrectomy and didn' t undertake any corticosteroid treatment.Main outcome measures:the rate of single-operation anatomic reattachment success,the rate of postoperative redetachment and the visual acuity.Results 18 eyes(62%)in Group A got choroidal reattachment in a week. ,the single op-eration anatomical rate of choroidal reattachment was 83.7% for Group A and 90.7% for Group B.The rate of anatomic retinal reattachment was 86.2% for Group A and 89.7% for Group B,the difference between them did not reach statistical significance (P>0.05).The vision improvement was a little more in Group B than that in Group A., however the rate of redetachment was almost the same after following-up.Cunclusions vitrectomy as early as possible played an important role in treatment of macular rhegmatogenous retinal detachment with choroidal detachment; the existence of choroidal detachment didn't have an effect on the reattachment of reti-nal detachment and the improvement of visual acuity.The corticosteroid administration prior to vitrectomy had no clinical significance.