频域OCT检测不同视网膜脱离复位术后黄斑中心凹视网膜厚度变化与视功能的关系

发布时间：2018-02-02 03:42

本文关键词： 频域光学相干断层扫描视网膜脱离黄斑玻璃体切割巩膜外加压　出处：《眼科新进展》2014年01期 　论文类型：期刊论文

【摘要】：目的探讨累及黄斑区的孔源性视网膜脱离(rhegmatogenous retinal detachment,RRD)患者,行不同手术方式治疗后频域光学相干断层扫描(optical coherence tomography,OCT)检测黄斑中心凹视网膜厚度变化及其与视力的相关性。方法累及黄斑区的RRD患者40例(40眼),其中巩膜外加压术组16例(16眼)、玻璃体切割联合惰性气体填充术组14例(14眼)和玻璃体切割联合硅油填充术组10例(10眼)。术后1周、1个月、3个月、6个月行OCT检查,观察黄斑中心凹视网膜厚度变化,行最佳矫正视力(best-corrected visual acuity,BCVA)检查。比较各组患者黄斑中心凹厚度差异,分析黄斑中心凹厚度与BCVA的相关性。结果术后所有患者视网膜脱离均解剖复位成功。术后1周巩膜外加压术组、玻璃体切割联合惰性气体填充术组、玻璃体切割联合硅油填充术组黄斑中心凹厚度分别为(361.44±88.32)μm、(359.86±89.67)μm、(361.60±84.71)μm,BCVA分别为0.13±0.07、0.14±0.09、0.13±0.08;术后1个月3组患者黄斑中心凹厚度分别为(328.81±90.74)μm、(264.93±28.38)μm、(272.40±26.84)μm,BCVA分别为0.26±0.13、0.45±0.20、0.50±0.12;术后3个月3组患者黄斑中心凹厚度分别为(279.06±57.90)μm、(262.57±34.58)μm、(270.90±30.30)μm,BCVA分别为0.47±0.17、0.49±0.19、0.55±0.14;术后6个月3组患者黄斑中心凹厚度分别为(261.75±47.13)μm、(251.07±24.96)μm、(253.90±22.76)μm,BCVA分别为0.48±0.16、0.56±0.15、0.58±0.13。术后1个月,与巩膜外加压术组相比,玻璃体切割联合惰性气体填充术组、玻璃体切割联合硅油填充术组黄斑中心凹厚度明显降低而BCVA明显提高,各组间差异均有统计学意义(均为P0.05)。两两比较显示:巩膜外加压术组黄斑中心凹厚度及BCVA术后3个月与术后6个月比较差异无统计学意义(P0.05),其余各时间段两两比较差异均有统计学意义(均为P0.05);玻璃体切割联合惰性气体填充术组及玻璃体切割联合硅油填充术组黄斑中心凹厚度及BCVA术后1周与其余各时间段比较差异均有统计学意义(均为P0.05),其余各时间段两两比较差异均无统计学意义(均为P0.05)。术后1周、1个月、3个月、6个月各组患者黄斑中心凹厚度与BCVA均呈负相关(均为P0.05)。结论频域OCT能定量观察RRD患者术后黄斑区的变化;与巩膜外加压术相比,采用玻璃体切割术治疗RRD术后黄斑区视网膜厚度恢复更快;不同的眼内填充物对黄斑区视网膜厚度恢复无影响;RRD术后黄斑区视网膜厚度与视力呈负相关。
[Abstract]:Objective to investigate rhegmatogenous retinal detachment (RRD) patients with rhegmatogenous retinal detachment (RRD) involving macular area. Optical coherence tomography was treated with different surgical methods in frequency domain optical coherence tomography (OCT). Methods 40 RRD patients with macular area involvement and 40 eyes with macular area were examined for retinal thickness changes and their correlation with visual acuity, including 16 eyes in the scleral compression group (n = 16). Vitrectomy combined with inert gas filling (14 eyes) and vitrectomy combined with silicone oil (10 eyes) were examined by OCT at 1 week, 1 month, 3 months and 6 months after operation. The retinal thickness of macular central fovea was observed and the best corrected visual acuity was performed. BCVA examination. The thickness of macular fovea in each group was compared. Results the retinal detachment was successfully reattached 1 week after surgery in the group of scleral compression vitrectomy combined with inert gas filling. The thickness of macular fovea in vitrectomy combined with silicone oil filling group was 361.44 卤88.32 渭 m and 359.86 卤89.67 渭 m respectively. BCVA (361.60 卤84.71) 渭 m was 0.13 卤0.07U 0.14 卤0.09U 0.13 卤0.08, respectively. The thickness of macular fovea was 328.81 卤90.74 渭 m, 264.93 卤28.38 渭 m, 272.40 卤26.84 渭 m, respectively. BCVA was 0.26 卤0.13, 0.45 卤0.20, 0.50 卤0.12, respectively. The thickness of macular fovea in the 3 groups was 279.06 卤57.90 渭 m, 262.57 卤34.58 渭 m, 270.90 卤30.30 渭 m, respectively. BCVA was 0.47 卤0.17, 0.49 卤0.19, 0.55 卤0.14, respectively. The thickness of macular fovea was 261.75 卤47.13 渭 m, 251.07 卤24.96 渭 m and 253.90 卤22.76 渭 m, respectively. The BCVA was 0.48 卤0.16 卤0.56 卤0.15 卤0.58 卤0.13 respectively. One month after the operation, the vitrectomy combined with inert gas filling group was compared with the group of scleral compression. The thickness of macular fovea in vitrectomy combined with silicone oil filling group was significantly decreased and BCVA was significantly increased. There was no significant difference in macular fovea thickness and BCVA between 3 months and 6 months after BCVA in each group (P0.05) (P < 0.05). The results showed that there was no significant difference in the thickness of macular fovea between the two groups (P < 0.05). P0.05). The differences in other time periods were statistically significant (P 0.05). The macular fovea thickness in vitrectomy combined with inert gas filling group and vitrectomy combined with silicone oil implantation group were significantly different from those in other time periods after BCVA (P < 0.05). All of them were P0.05). There was no significant difference between the two groups in the other time periods (all P0.05A. 1 week, 1 month, 3 months after operation). There was a negative correlation between macular fovea thickness and BCVA in each group at 6 months (all P 0.05). Conclusion OCT in frequency domain can quantitatively observe the changes of macular area in patients with RRD after operation. Compared with scleral compression, the retinal thickness of macular area recovered more quickly after RRD by vitrectomy. Different intraocular fillers had no effect on the recovery of retinal thickness in macular area. The retinal thickness of macular area was negatively correlated with visual acuity after RRD.
【作者单位】：上海市奉贤区中心医院眼科;
【分类号】：R779.6
【正文快照】： 孔源性视网膜脱离(rhegmatogenous retina detachment,RRD)是眼科常见的严重的致盲性眼病。RRD手术成功的标准是视网膜神经上皮层的解剖复位。随着医疗技术的进步,RRD手术的解剖复位成功率可以达到90%[1]。然而,视网膜成功复位后,视功能的恢复往往较差。光学相干断层扫描(opti

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