单眼中心性浆液性脉络膜视网膜病变病眼与健眼黄斑厚度差异及临床意义

发布时间：2018-03-21 12:18

本文选题：体层摄影术　切入点：光学相干　出处：《广西医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的分析单眼中心性浆液性脉络膜视网膜病变中,发病眼与对侧健康眼黄斑区神经上皮层的形态学差异,及其临床意义。方法研究对象为单眼发病,对侧眼无病变的中心性浆液性脉络膜视网膜病变患者,共67例入组。对比发病眼与对侧眼最佳矫正视力,屈光状态,中心凹神经上皮厚度间的差异。按照双眼间中心凹厚度的差值将病例分成2组：非变薄组发病眼的中心凹厚于或等于对侧眼；变薄组发病眼的中心凹薄于对侧眼。分析2组间年龄,病程,视力,双眼视力差值,中心凹处网膜总高度,中心凹厚度,网膜下液高度等参数是否存在差异。此外,分别在全体病例,非变薄组与变薄组内进行针对视力,中心凹厚度与其他指标之间的双变量相关性分析。结果发病眼的矫正视力为0.6(0.4-0.8),对侧眼的矫正视力为1.0(1.0-1.2),2组间差异有统计学意义(Z=-6.507,P0.01)。发病眼中心凹神经上皮层厚度为161.80±29.33um,对侧眼中心凹神经上皮层厚度为175.06±16.29um,2组间差异有统计学意义(t=-3.982,P0.01)。全体病例中,发病眼最佳矫正视力与视网膜总高度(r=-0.289,P0.05),视网膜下液高度(r=-0.361,P0.01),中心凹神经上皮层厚度(r=0.385,P0.01)的相关性具有统计学意义。发病眼中心凹神经上皮层厚度与病程(r==-0.286,P0.05),与最佳矫正视力的相关性具有统计学意义。分组以后分析显示,非变薄组的最佳矫正视力为0.80(0.50-0.95),变薄组的最佳矫正视力为0.50(0.30-0.60),2组间差异有统计学意义(Z=-3.161,P0.01)。非变薄组的病程为12天(7-30天),变薄组的病程为30天(14-60天),2组差异有统计学意义(Z=-2.683,P0.01)。在非变薄组内,最佳矫正视力与年龄(r=-0.407,P0.05),视网膜下液高度(r==-0.396,P0.05)的相关性有统计学意义,中心凹神经上皮层厚度与年龄(r=0.448,P0.05)的相关性有统计学意义。在变薄组内,最佳矫正视力,中心凹神经上皮层厚度与其它指标间的相关性分析结果均没有统计学意义。结论在单眼中心性浆液性脉络膜视网膜病变中,发病眼与对侧健康眼的中心凹厚度存在差异性。这种差异性包含了患者的病程与视功能方面的信息。当发病眼中心凹厚度薄于对侧眼时,提示相对更长的病程,更严重的视力损害。
[Abstract]:Objective to analyze the morphologic differences and clinical significance of neuroepithelium in monocular central serous chorioretinopathy between the affected eyes and the contralateral healthy eyes. Methods Sixty-seven patients with central serous chorioretinopathy without contralateral eye involvement were enrolled in the study. The best corrected visual acuity and refractive state were compared between the affected eyes and the contralateral eyes. According to the difference of the thickness of the central fovea between the eyes, the patients were divided into two groups: the fovea of the non-thinning group was thicker than or equal to that of the contralateral eye; Age, course of disease, visual acuity, binocular visual acuity difference, total height of omentum at fovea, thickness of fovea, height of subomentum fluid were analyzed in the thinning group. The correlation between vision, fovea thickness and other parameters was analyzed in all cases, non-thinning group and thinning group. Results the corrected visual acuity of the affected eyes was 0.6 ~ 0.4-0.80.The corrected visual acuity of the contralateral eye was 1.0 ~ 1.0-1.2 / 2. There was significant difference between the two groups. The thickness of the central foveal epithelium layer was 161.80 卤29.33 um. the thickness of the contralateral central foveal neuroepithelial layer was 175.06 卤16.29 um2. In all cases, The correlation between the best corrected visual acuity (BCVA) and the total retinal height (r-0.289), the subretinal fluid height (r-0.361) and the thickness of central foveal neuroepithelial layer (RNEC) were statistically significant. The thickness of neuroepithelial layer in the central fovea and the course of disease were significantly correlated with the best correction. The correlation of visual acuity was statistically significant. The best corrected visual acuity (BCVA) of the non-thinning group was 0.80,0.50-0.95g, and the best corrected visual acuity of thinning group was 0.50,0.30-0.600.The difference between the two groups was statistically significant. The course of disease in non-thinning group was 12 days, 7-30 days, and the course of disease in thinning group was 30 days 14-60 days. In the non-thinning group, The correlation between the best corrected visual acuity (BCVA) and the age (r) -0.407 (P0.05), the height of the subretinal fluid (RV) -0.396 (P0.05) was statistically significant, and the correlation between the thickness of the neuroepithelium layer of the fovea and the age (P _ (0.05)) was statistically significant. In the thinning group, the best corrected visual acuity was the best. There was no significant correlation between the thickness of the neuroepithelial layer of the fovea and other indexes. Conclusion in monocular central serous chorioretinopathy, There is a difference in the foveal thickness between the affected eye and the contralateral healthy eye. This difference contains information about the course of the disease and visual function. When the foveal thickness of the affected eye is thinner than that of the contralateral eye, it indicates a longer course of disease. More severe visual impairment.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R773.4

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