使用谱域光相关断层扫描观察玻璃体手术联合空气填充治疗特发性黄斑裂孔术后的光感受器层改变

发布时间：2018-10-31 09:18

【摘要】：目的观察玻璃体切除手术联合空气填充治疗特发性黄斑裂孔(idiopathic macular hole, IMH)术后的光感受器细胞层的改变。方法回顾性分析了北京协和医院眼科采用玻璃体切除手术联合空气填充治疗的特发性黄斑裂孔病例,使用谱域光相干断层扫描(spectral-domain optical coherence tomography, SD-OCT)测量裂孔直径及光感受器细胞层的破坏直径,并研究其与术前、术后的最佳矫正视力、裂孔闭合率等数据间的相关性。采用SPSS 14.0统计软件进行统计分析：对数据间相关性进行分析时,采用Bivariate过程的Pearson相关法;对同一病例的术前、术后数据进行比较时,采用配对样本t检验。结果共连续纳入35人35眼,术前换算为最小可分辨视角的对数值(logarithm of the minimal angle of resolution, logMAR)的最佳矫正视力(best corrected visual acuity, BCVA) 0.40-2.20(平均1.15),黄斑裂孔直径399-1616μm(平均861.8μm),光感受器细胞层破坏的直径867-3444μm(平均2087.9pm)。术后1个月时,裂孔闭合率为71.4%, logMAR为0.30-2.50(平均0.99),光感受器细胞层破坏的直径304-2553μm(平均1424.8μm),视力较术前有显著提高,光感受器细胞层破坏的直径则显著缩小。并且,术前的裂孔直径及术后的光感受器细胞层破坏直径与术后视力具有显著相关性。结论玻璃体切除手术联合空气填充治疗特发性黄斑裂孔是有效并安全的,可以明显减少患者术后保持俯卧位的时间。术前的裂孔直径及术后的光感受器细胞层破坏直径是预测术后视力的最敏感指标。
[Abstract]:Objective to observe the changes of photoreceptor cell layer after vitrectomy combined with air filling in the treatment of idiopathic macular hole (idiopathic macular hole, IMH). Methods the patients with idiopathic macular hole treated by vitrectomy combined with air filling in Peking Union Hospital were analyzed retrospectively. Spectral domain optical coherence tomography (spectral-domain optical coherence tomography,) was used. SD-OCT) was used to measure the diameter of the hole and the diameter of damage to the cell layer of the photoreceptor, and to study the correlation between the diameter of the hole and the data of the best corrected visual acuity and the rate of closure of the hole before and after the operation. SPSS 14.0 statistical software was used for statistical analysis: when the correlation between data was analyzed, the Pearson correlation method of Bivariate process was used, and the paired sample t test was used to compare the data before and after operation of the same case. Results 35 patients (35 eyes) were included in the study. The optimal corrected visual acuity (best corrected visual acuity, BCVA) 0.40-2.20 (mean 1.15) of the logarithmic value (logarithm of the minimal angle of resolution, logMAR) converted to the least discernible angle was obtained. The diameter of macular hole was 399-1616 渭 m (average 861.8 渭 m),). The diameter of cell layer destruction was 867-3444 渭 m (average 2087.9pm). At 1 month after operation, the closure rate of the hole was 71.4 and the logMAR was 0.30-2.50 (mean 0.99). The diameter of the cell layer destruction of the photoreceptor was 304-2553 渭 m (mean 1424.8 渭 m),). The diameter of photoreceptor cell layer damage was significantly reduced. The diameter of the hole before operation and the diameter of photoreceptor cell layer destruction after operation were significantly correlated with postoperative visual acuity. Conclusion Vitrectomy combined with air filling is effective and safe in the treatment of idiopathic macular hole and can significantly reduce the time of supine position. The diameter of the hole before operation and the diameter of photoreceptor cell layer destruction after operation were the most sensitive indexes for predicting postoperative visual acuity.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.6

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