부산대학교 도서관

Purpose: We assess the merits of pars plana vitrectomy (PPV) in subjects with good visual acuity (VA) and a chronic macula-involving tractional retinal detachment (TRD) secondary to proliferative diabetic retinopathy (PDR). Methods: A retrospective review of medical records was undertaken. Subjects were divided into 1) a Study Group of subjects who underwent prompt PPV and 2) a Control Group of subjects in which PPV was deferred in favor of less invasive treatment options or observations. Both study and control subjects had a baseline Snellen VA of [greater than or equal to] 20/50 and a PDR-associated macula-involving TRD of >6 months duration with a minimum follow-up of 12-months. Results: There were 58 patients analyzed over an average follow-up period of 27.6 ([+ or -]7.1) months. The change in VA was similar in the Study Group compared to the Control Group (p=0.94) with both groups losing about three lines of VA during the study period (-0.30 [+ or -]0.52 logMAR). Although the rates of maintaining [greater than or equal to] 20/200 Snellen VA and [greater than or equal to] 20/50 Snellen VA were similar in the Study Group compared to the Control Group (p=0.55 and p=0.28, respectively), the Study Group had more subjects gaining [greater than or equal to] 2 lines of VA during the study period (p=0.002). Conclusion: Patients presenting with good VA and a PDR-associated macula- involving TRD of >6 months were more likely to gain [greater than or equal to] 2 lines of VA when PPV was performed at baseline compared to PPV deferral until further deterioration occurred. Keywords: chronic tractional retinal detachment, diabetic vitrectomy, good visual acuity
Introduction Tractional retinal detachment (TRD) involving or threatening the center of the macula is one of the principal indications for pars plana vitrectomy (PPV) in proliferative diabetic retinopathy (PDR) patients [...]