玻璃体内惰性气体填充联合激光光凝治疗高度近视性黄斑劈裂患者疗效观察

发布时间：2018-11-28 09:15

【摘要】：目的观察并分析玻璃体内C_3F_8气体填充联合黄斑区视网膜激光光凝治疗高度近视性黄斑劈裂患者的疗效。方法回顾性分析了高度近视性黄斑劈裂患者14例(18眼)。所有患者均接受0.5~0.7 m L C_3F_8气体眼内填充,在1周后行黄斑区视网膜激光光凝治疗,观察患者治疗前后的最佳矫正视力(best-corrected visual acuity,BCVA),OCT检测黄斑区中心凹视网膜厚度(central foveal thickness,CFT)和黄斑区视网膜最大厚度(maximal macular thickness,MMT)。结果 OCT检查显示治疗前CFT为(494.00±454.80)μm,治疗后末次随访下降到(193.61±97.42)μm,差异有统计学意义(P=0.01);治疗前MMT为(687.33±385.15)μm,治疗后下降至(331.06±109.31)μm,差异亦有统计学意义(P=0.001)。在末次随访时中心凹处劈裂完全或部分愈合的14眼,治疗前CFT为(567.36±493.01)μm,治疗后下降至(171.43±90.84)μm,差异有统计学意义(P=0.006);MMT治疗前为(744.14±417.38)μm,治疗后下降至(303.86±83.62)μm,差异有统计学意义(P=0.002)。所有患者治疗前BCVA为(0.94±0.39)log MAR,其中13眼的BCVA0.6 log MAR;在末次随访时,BCVA提高到(0.92±0.36)log MAR,与治疗前相比差异无统计学意义(P=0.78)。中心凹处劈裂完全或部分愈合的14眼,治疗前BCVA为(1.04±0.37)log MAR;治疗后提高到(0.90±0.34)log MAR,与治疗前相比差异亦无统计学意义(P=0.16)。在末次随访时,4眼视力提高2行及以上,10眼的视力不变。所有患者在治疗后均无中心暗点等视觉症状,未出现眼压升高。结论玻璃体内C_3F_8气体填充联合黄斑区视网膜激光光凝治疗高度近视性黄斑劈裂患者有较好疗效。
[Abstract]:Objective to observe and analyze the effect of intravitreal C_3F_8 gas implantation combined with retinal laser photocoagulation on high myopic macular splitting. Methods 14 cases (18 eyes) of high myopia macular splitting were analyzed retrospectively. All the patients were treated with 0.5 渭 m / L C_3F_8 gas and 1 week later, the best corrected visual acuity (best-corrected visual acuity,BCVA) was observed by laser photocoagulation in the macular area, and the best corrected visual acuity (best-corrected visual acuity,BCVA) was observed before and after the treatment. The macular area retinal thickness (central foveal thickness,CFT) and the maximum macular retinal thickness (maximal macular thickness,MMT) were measured by OCT. Results OCT showed that CFT was (494.00 卤454.80) 渭 m before treatment and decreased to (193.61 卤97.42) 渭 m at the last follow-up after treatment (P0.01). MMT was (687.33 卤385.15) 渭 m before treatment and decreased to (331.06 卤109.31) 渭 m after treatment. At the last follow-up, the CFT of 14 eyes with complete or partial healing of the central fovea was (567.36 卤493.01) 渭 m before treatment, and decreased to (171.43 卤90.84) 渭 m after treatment. The difference was statistically significant (P0. 006). MMT was (744.14 卤417.38) 渭 m before treatment and decreased to (303.86 卤83.62) 渭 m after treatment (P0. 002). The BCVA of all patients before treatment was (0.94 卤0.39) log MAR,). At the last follow-up, the BCVA of 13 eyes increased to (0.92 卤0.36) log MAR,. There was no significant difference between before and after treatment (P0. 78). In 14 eyes with complete or partial healing of the central fovea, the BCVA was (1.04 卤0.37) log MAR;) before and after treatment (0.90 卤0.34) log MAR,), and there was no significant difference between the two groups (P0. 16). At the last follow-up, the visual acuity of 4 eyes improved by 2 or more lines, and the visual acuity of 10 eyes remained unchanged. All the patients had no visual symptoms such as central dark spot and no elevation of intraocular pressure after treatment. Conclusion intravitreal C_3F_8 gas implantation combined with retinal laser photocoagulation in macular area is effective in the treatment of high myopic macular splitting.
【作者单位】：中山大学中山眼科中心海南眼科医院(海南省眼科医院) 海南省眼科重点实验室;
【基金】：海南省卫生和计划生育委员会普通医学科研项目(编号:琼卫2014资助-055号)~~
【分类号】：R779.63

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