光学相干断层扫描评价孔源性视网膜脱离的玻璃体手术疗效

发布时间：2019-05-11 08:43

【摘要】：目的利用光学相干断层扫描(optical coherence tomography,OCT)评价孔源性视网膜脱离患者行玻璃体手术的疗效。方法回顾性分析94例(94眼)孔源性视网膜脱离患者资料。根据术前OCT检查黄斑区视网膜是否脱离分为两组:A组(黄斑区神经上皮脱离)和B组(黄斑区神经上皮未脱离),所有患者均行玻璃体切割联合视网膜光凝及硅油填充术,记录术前及术后3个月最佳矫正视力、眼压、前置镜及OCT眼底检查结果。结果术后3个月,两组最佳矫正视力与术前相比提高,差异均有统计学意义(均为P0.05),B组提高程度高于A组(P0.05);两组术前术后眼压及术后视网膜脱离复发率比较,差异均无统计学意义(均为P0.05);黄斑形态异常(黄斑神经上皮下积液、黄斑水肿、黄斑前膜)的发生率A组(55.6%)高于B组(22.5%)(P0.05);其中,黄斑水肿者的中心凹视网膜厚度值与BCVA具有相关关系(P0.05),黄斑神经上皮下积液者的中心凹视网膜厚度值与BCVA无明显相关性(P0.05)。结论 OCT可作为孔源性视网膜脱离玻璃体手术疗效评价的重要工具,尤其对于脱离范围波及黄斑区的患者,OCT随诊具有重要价值。
[Abstract]:Objective to evaluate the efficacy of vitreous surgery in patients with rhegmatogenous retinal detachment by optical coherence tomography (optical coherence tomography,OCT). Methods the data of 94 patients (94 eyes) with macular retinal detachment were analyzed retrospectively. According to preoperative OCT, retinal detachment in macular area was divided into two groups: group A (macular neuroepithelial detachment) and group B (macular neuroepithelial detachment). All patients underwent vitrectomy combined with retinal photocoagulation and silicone oil filling. The best corrected visual acuity, intraocular pressure (IOP), anterior endoscopy and OCT fundus examination were recorded before and 3 months after operation. Results at 3 months after operation, the best corrected visual acuity of the two groups was significantly higher than that before operation (both P 0.05). The improvement degree of), B group was higher than that of A group (P 0.05). There was no significant difference between the two groups in intraocular pressure (IOP) before and after operation and the recurrence rate of retinal detachment (P 0.05). The incidence of macular morphological abnormalities (macular subepithelial effusion, macular edema, macular membrane) in group A (55.6%) was higher than that in group B (22.5%) (P0.05). Among them, the fovea retinal thickness was correlated with BCVA in macular edema patients (P0.05), and there was no significant correlation between fovea retinal thickness and BCVA in macular subepithelial effusion (P0.05). Conclusion OCT can be used as an important tool to evaluate the curative effect of vitreous surgery for macular retinal detachment, especially for patients with macular area. OCT follow-up is of great value.
【作者单位】：郑州大学第一附属医院眼科;
【分类号】：R779.6

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