RESUMEN
The visual outcome of 74 eyes with the ocular histoplasmosis syndrome and active subfoveal subretinal neovascular membranes was studied retrospectively. Follow-up time ranged from 12 to 109 months (median, 36.5 months). Ten eyes (14%) retained visual acuity of 20/40 or better. Fifty-seven eyes (77%) suffered visual loss of 20/100 or worse and 36 eyes (49%) suffered visual loss of 20/400 or worse. Factors significantly associated with retaining vision of 20/40 or better were: age less than 30 years (P = 0.008); smaller membrane size (P = 0.0002); and absence of visual loss secondary to ocular histoplasmosis in the fellow eye (P = 0.053). Factors significantly associated with vision decreasing by four or more lines were: older patient age (P = 0.006); better initial visual acuity (P = 0.090); and more than 50% involvement of the foveal avascular zone (P = 0.059). These results were confirmed by multiple logistic regression. Final vision of 20/40 or better was associated with better initial visual acuity using univariate analysis, but this result was not confirmed by multiple logistic regression.
Asunto(s)
Coroides/patología , Oftalmopatías/complicaciones , Histoplasmosis/complicaciones , Neovascularización Patológica/etiología , Adulto , Factores de Edad , Anciano , Femenino , Angiografía con Fluoresceína , Fóvea Central , Humanos , Masculino , Persona de Mediana Edad , Neovascularización Patológica/patología , Pronóstico , Estudios Retrospectivos , Agudeza VisualRESUMEN
The authors used vitreous surgery to treat 514 cases with retinal detachment. Three hundred sixty-five (71%) of the 514 eyes had retinal detachment associated with proliferative diabetic retinopathy. A successful anatomic result was achieved in 245 (67%) of these 365 cases and 227 (62%) obtained final vision of 5/200 or better. Five factors were associated with a successful visual result in diabetic eyes: (1) preoperative visual acuity of 5/200 or better, (2) retaining the crystalline lens, (3) an attached macula preoperatively, (4) preoperative retinal detachment limited to the posterior pole or less than one quarter the fundus area, and (5) absence of iatrogenic retinal breaks. Of those cases without diabetic retinopathy, a successful anatomic result was achieved in (1) 27 (84%) of 32 eyes with nondiabetic traction detachment, (2) 13 (65%) of 20 giant retinal tears, (3) 21 (50%) of 42 eyes with opaque media complicating retinal detachment, (4) 9 (90%) of 10 eyes with posterior retinal breaks, (5) 29 (42%) of 69 eyes with advanced proliferative vitreoretinopathy (PVR), and (6) 29 (64%) of 45 eyes with retinal detachment complicating prior ocular trauma.