糖尿病性玻璃体视盘牵拉和黄斑水肿

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Purpose: To describe an association between optic disc traction and diabetic m acular oedema (DME) unresponsive to laser treatment. Methods: A retrospective re view of all patients with DME who attended our clinic between September 2001 and November 2003 was undertaken. The patients had undergone ophthalmic history and examination, fluorescein angiography, and optical coherence tomography (OCT) of the macular area and optic nerve head (ONH). A total of 10 nonvitrectomized eye s thatwere found to have an elevation of the ONHsecondary to vitreopapillary tra ction were included in the analysis. Eyes with additional traction at the poster ior pole were excluded. Results: Out of the 10 eyes (seven patients, aged 47-79 years)-with vitreo-papillary traction, nine had previously undergone argon la ser photocoagulation(s) for DME. In seven eyes (seven patients), OCT verified th e vitreopapillary traction as the sole traction, whereas in the fellow eyes of t hree patients vitreomacular traction was evident as well. In the seven eyes with only vitreopapillary traction, OCT demonstrated parapapillary serous retinal de tachment in two eyes and a diffuse DME in all eyes (mean foveal thickness, 396± 144μm). Maximal thickness of the papillo-macular bundle site was adjoining the elevated ONH in three eyes, and was maximal at the central macula in the other four eyes. Ultrasonography (n=5) revealed an incomplete detachment of the poster ior hyaloid in each, adherent only at the ONH. Conclusions: Diffuse DME unresponsive to laser treatment may be assoc iated with vitreopapillary traction. Further studies should indicate whether the se two phenomena could suggest a cause and effect in such eyes. Purpose: To describe an association between optic disc traction and diabetic m acular oedema (DME) unresponsive to laser treatment. Methods: A retrospective re view of all patients with DME who attended our clinic between September 2001 and November 2003 was undertaken. The patients had undergone ophthalmic history and examination, fluorescein angiography, and optical coherence tomography (OCT) of the macular area and optic nerve head (ONH). A total of 10 nonvitrectomized eye s that that was found to have an elevation of the ONHsecondary to vitreopapillary tra ction were included in the analysis. Eyes with additional traction at the poster ior pole were excluded. Results: Out of the 10 eyes (seven patients, aged 47-79 years) -with vitreo-papillary traction, nine ago previously undergone argon la ser photocoagulation (s ) for seven eyes (seven patients), OCT verified th e vitreopapillary traction as the sole traction, while in the fellow eyes of t hree patients vitreomacular traction was clear as well. In the seven eyes with only vitreopapillary traction, OCT demonstrated parapapillary serous retinal de tachment in two eyes and a diffuse DME in all eyes (mean foveal thickness, 396 ± 144 μm). Maximal thickness of the papillo-macular bundle site was adjoining the elevated ONH in three eyes, and was maximal at the central macula in the other four eyes. Ultrasonography (n = 5) revealed an incomplete detachment of the poster ior hyaloid in each, adherent only at the ONH. Conclusions: Diffuse DME unresponsive to laser treatment may be assocated with vitreopapillary traction. Further studies should indicate whether the se two phenomena could suggest a cause and effect in such eyes.
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