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Macular buckling versus vitrectomy alone in macular hole-related retinal detachment
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OBJETIVO: O descolamento de retina associado a buraco macular é uma das fases finais da maculopatia miópica tracional. A abordagem cirúrgica do descolamento de retina associado a buraco macular apresenta dificuldades do ponto de vista técnico e a técnica cirúrgica mais eficaz é ainda alvo de debate entre especialistas. O objetivo deste trabalho é oferecer uma perspetiva global da maculopatia miópica tracional, incluindo as suas características clínicas, fisiopatologia, e ilustrar os possíveis achados na tomografia de coerência ótica em cada fase desta patologia. Através de uma revisão da literatura, este trabalho explora o papel da colocação de depressor macular e/ou da vitrectomia via pars plana no tratamento do descolamento de retina associado a buraco macular e expõe as limitações atuais na sua abordagem. MÉTODOS: Foi realizada uma revisão da literatura desde a origem até Dezembro de 2022 através da base de dados eletrónica PubMed (MEDLINE), usando as palavras: myopic traction maculopathy, macular hole, retinal detachment, macular hole-related retinal detachment, macular buckle, vitrectomy, combinadas de várias formas. CONCLUSÃO: A colocação de depressor macular parece apresentar resultados superiores em olhos com maior comprimento axial e estafiloma posterior, quando comparado com a vitrectomia via pars plana. Uma intervenção combinada das duas técnicas também pode ser eficaz.
PURPOSE: Macular hole-related retinal detachment is one of the final stages of myopic traction maculopathy. The surgical management of macular hole-related retinal detachment presents difficulties, and the most efficient surgical technique is still a subject of debate among the experts. The purpose of this work is to offer a comprehensive perspective of myopic traction maculopathy, including its clinical characteristics, pathogenesis, and to illustrate optical coherence tomography findings in each of its pathological stages. By reviewing the existing literature, this work explores the role played by macular buckling and/or pars plana vitrectomy in the treatment of macular hole-related retinal detachment and exposes the current limitations in its management. METHODS: A literature review from inception to December 2022 was carried out using an electronic database search on PubMed (MEDLINE), using the keywords: myopic traction maculopathy, macular hole, retinal detachment, macular hole-related retinal detachment, macular buckle, vitrectomy, combined in different ways. CONCLUSION: Macular buckling seems to have superior results in eyes with longer axial lengths or posterior staphyloma, when compared to pars plana vitrectomy alone. A combined intervention of both techniques may also be effective.
PURPOSE: Macular hole-related retinal detachment is one of the final stages of myopic traction maculopathy. The surgical management of macular hole-related retinal detachment presents difficulties, and the most efficient surgical technique is still a subject of debate among the experts. The purpose of this work is to offer a comprehensive perspective of myopic traction maculopathy, including its clinical characteristics, pathogenesis, and to illustrate optical coherence tomography findings in each of its pathological stages. By reviewing the existing literature, this work explores the role played by macular buckling and/or pars plana vitrectomy in the treatment of macular hole-related retinal detachment and exposes the current limitations in its management. METHODS: A literature review from inception to December 2022 was carried out using an electronic database search on PubMed (MEDLINE), using the keywords: myopic traction maculopathy, macular hole, retinal detachment, macular hole-related retinal detachment, macular buckle, vitrectomy, combined in different ways. CONCLUSION: Macular buckling seems to have superior results in eyes with longer axial lengths or posterior staphyloma, when compared to pars plana vitrectomy alone. A combined intervention of both techniques may also be effective.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Palavras-chave
Alta miopia Maculopatia tracional miópica Descolamento de retina associado a buraco macular Vitrectomia via pars plana Depressão macular Oftalmologia