孔源性视网膜脱离外路术后黄斑下积液的OCT观察及相关因素分析

发布时间：2018-05-25 04:23

本文选题：光学相干断层扫描 + 巩膜扣带术　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的:对孔源性视网膜脱离(RRD)外路复位术后进行黄斑部光学相干断层扫描(OCT)检查,观察术后黄斑区积液情况,并分析其相关因素。方法:选择2015年8月-2016年12月到我院就诊,均采取巩膜扣带手术治疗且术后视网膜均复位成功的孔源性视网膜脱离患者,共有40例(40只眼),分别于术后半个月、1、3、6个月行最佳矫正视力(BCVA)、光学相干断层扫描(OCT)检查。按积液情况及积液吸收时间长短分组,术后半个月黄斑下无积液,即无积液组;术后1个月黄斑下积液吸收,即1月组;术后3个月黄斑下积液吸收,即3月组;术后6个月黄斑下积液吸收,即6月组,对其进行统计学分析。结果:术后半月黄斑下无积液19眼(无积液组)占47.5%。有积液21眼,占52.5%,其中1月组10眼,3月组6眼,6月组5眼。手术前患者平均log MAR视力为1.29±0.72,术后各组平均log MAR视力分别为0.31±0.23、0.35±0.26、0.55±0.39、0.71±0.34,经单因素方差分析,各组视力较术前均有所提高,差异有统计学意义(P0.05)。无积液组、1月组患者视力比较无统计学意义(P0.05),1月组和3月组患者视力比较有统计学意义(P0.05),3月组和6月组患者视力比较有统计学意义(P0.05)。术后各组最佳矫正视力提高2行以上者所占比重分别为84.2%、80.0%、66.7%、60.0%。但四组之间相互比较差异无统计学意义(P=0.552)。收集术后各组OCT扫描资料,经相关统计学分析,视网膜脱离范围及视网膜脱离时间为影响黄斑下积液吸收的因素(rs=0.544,P0.001、rs=0.716,P0.001)。结论:OCT可清晰显示黄斑部视网膜结构,是评价RRD外路复位术后视网膜形态功能及视网膜下液情况不可或缺的影像学检查手段,可为第一时间就发现病变和诊治疾病提供重要信息;视网膜脱离范围及视网膜脱离时间长短对术后黄斑下积液吸收有影响,同时黄斑下积液吸收时间长短可影响患者术后视力恢复,积液持续时间越长对患者视力损害也就越大。
[Abstract]:Objective: to examine the macular optical coherence tomography (OCT) after external reposition of orrhea retinal detachment (RRD) and observe the effusion of the macular region after operation, and to analyze the related factors. Methods: the scleral buckling surgery was adopted in December -2016 August 2015, and the pore origin of retinal reposition after operation was successfully treated. The patients with retinal detachment had 40 cases (40 eyes). The best corrected visual acuity (BCVA) and optical coherence tomography (OCT) were performed at half a month after the operation, and OCT (optical coherence tomography). The effusion was divided into groups according to the condition of effusion and the time of absorption of effusion. No effusion in the macula after the operation, that is, no effusion group, and the absorption of submacular effusion in the group of 1 months after the operation, that is, in the January group and 3 after the operation. The absorption of submacular effusion, that is, in the March group, the absorption of submacular effusion in the group of 6 months after operation, that is, in the June group, was statistically analyzed. Results: 19 eyes (no effusion group) accounted for 21 eyes of 47.5%., accounting for 52.5%, 10 eyes in January group, 6 in March group and 5 in June group. The average visual acuity of log MAR before operation was 1.29 + 0.72 after operation. The visual acuity of group average log MAR was 0.31 + 0.23,0.35 + 0.26,0.55 + 0.39,0.71 + 0.34 respectively. After single factor analysis of variance, the visual acuity of each group was improved, the difference was statistically significant (P0.05). There was no statistical significance (P0.05) in the group of January group (P0.05), March and March (P0.05), and March (P0.05), and March. The visual acuity of the patients in the group and the June group was statistically significant (P0.05). The proportion of the best corrected visual acuity above 2 lines was 84.2%, 80%, 66.7%, and 60.0%., respectively, but there was no significant difference between the four groups (P=0.552). The OCT scanning data of all groups after the operation were collected, and the range of retinal detachment and visual acuity were analyzed by correlation statistics. The time of retinal detachment is a factor affecting the absorption of submacular effusion (rs=0.544, P0.001, rs=0.716, P0.001). Conclusion: OCT can clearly display the retinal structure of the macular region. It is an indispensable imaging method to evaluate retinal morphological function and subretinal fluid after external reduction of RRD. It can be found for the first time for pathological changes and diagnosis and treatment. Disease provides important information. Retinal detachment and retinal detachment time affect the postoperative absorption of submacular effusion, and the absorption time of submacular effusion can affect the recovery of postoperative visual acuity. The longer the duration of liquid accumulation, the greater the visual impairment of the patients.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R779.6

【相似文献】