特发性黄斑裂孔玻璃体切割术后视力恢复及黄斑解剖愈合的相关因素分析

发布时间：2018-04-03 04:32

  本文选题：特发性黄斑裂孔　切入点：玻璃体切割术　出处：《眼科新进展》2015年05期

【摘要】：目的探讨特发性黄斑裂孔玻璃体切割术后影响视力恢复及黄斑解剖愈合的相关因素。方法 49例49眼特发性黄斑裂孔行玻璃体切割联合内界膜剥离术的患者纳入本研究。行最佳矫正视力(best corrected visual acuity,BCVA)(log MAR)检查、裂隙灯显微镜及间接检眼镜等检查,同时采用光学相干断层扫描检测黄斑裂孔基底直径、裂孔边缘高度及裂孔最小径,计算黄斑裂孔指数(macular hole index,MHI)、黄斑裂孔牵拉指数(tractional hole index,THI),对黄斑裂孔愈合情况分类。观察术后6个月时视力恢复及黄斑裂孔愈合情况,并与年龄、病程、术前BCVA、裂孔基底直径、裂孔高度、裂孔最小径、MHI、THI等进行相关性分析。结果术后BCVA为(0.45±0.29)log MAR,与术前BCVA(0.89±0.34)log MAR相比差异具有统计学意义(t=34.2,P=0.000)。术后裂孔基底直径为(432.1±90.7)μm,裂孔边缘高度为(214.0±81.3)μm,裂孔最小径为(195.3±86.2)μm,均较术前明显减小,差异均有统计学意义(均为P=0.000);术后49眼中,裂孔完全愈合者31眼(63.3%),部分愈合者14眼(28.6%),未愈合者4眼(8.2%)。相关性分析结果表明,术后BCVA(log MAR)与年龄、病程、术前BCVA(log MAR)均无相关性(均为P0.05),而与MHI、THI显著相关(r=0.763,P=0.000;r=0.814,P=0.000);黄斑裂孔愈合类型与裂孔基底直径、裂孔边缘高度、裂孔最小径、MHI、THI均显著相关(均为P0.05),而与术前BCVA、病程、年龄无相关性(均为P0.05)。结论MHI、THI可作为预测术后视力恢复及黄斑裂孔愈合的指标。
[Abstract]:Objective to investigate the factors influencing visual acuity and macular anatomic healing after vitrectomy of idiopathic macular hole.Methods 49 cases (49 eyes) of idiopathic macular hole underwent vitrectomy combined with internal membrane dissection.The best corrected visual acuity test, slit lamp microscope and indirect ophthalmoscope were performed. The basal diameter, edge height and minimum diameter of macular hole were examined by optical coherence tomography.The macular hole index (MHI) and the macular hole pulling index (MHI) were calculated. The macular hole healing was classified.The visual acuity and macular hole healing were observed 6 months after operation. The correlation analysis was made with age, course of disease, preoperative BCVA, basal diameter, hiatus height and MHITHI.Results the postoperative BCVA was 0.45 卤0.29)log Mar, which was significantly higher than that of preoperative BCVA(0.89 卤0.34)log MAR.The diameter of the basal hole was 432.1 卤90.7 渭 m, the height of the edge of the hole was 214.0 卤81.3 渭 m, and the minimal diameter of the hole was 195.3 卤86.2) 渭 m. The difference was statistically significant (P < 0.01).The hiatus healed completely in 31 eyes (63. 3%), partially healed in 14 eyes (28. 6%), and did not heal in 4 eyes (8. 2%).鐩稿叧鎬у垎鏋愮粨鏋滆〃鏄，

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