黄斑光学相干断层扫描图像与孔源性视网膜脱离术后视力变化的相关性分析  

Correlative analysis of visual recovery after rhegmatogenous retinal detachment surgery and macular images observing by optical coherence tomography

作　　者：梅海峰[1] 邢怡桥[1] 江双红[1] 

机构地区：[1]武汉大学人民医院眼科,武汉大学医学院眼科研究所,湖北省武汉市430060

出　　处：《眼科新进展》2006年第2期127-129,共3页Recent Advances in Ophthalmology

摘　　要：目的 观察波及黄斑区的非复杂性孔源性视网膜脱离术后各时期黄斑区光学相干断层扫描图像特征，分析其与视力恢复过程的对应关系。方法对28例28眼波及黄斑区的非复杂性孔源性视网膜脱离经巩膜外加压术视网膜成功复住的患者分别于术后1周、1月、3月、6月、12月行光学相干断层扫描检查，观察黄斑区形态变化，并分析其与相应时间段内视力变化的关系。结果术后1周所有患者均有不同程度的视网膜神经上皮下积液存留，随着时间的延长，积液不断吸收，至术后12月时，仍有3例视网膜神经上皮下存在少量积液，其余积液全部吸收。与之相对应，随着神经上皮下积液的不断吸收，患者视力逐渐提高，术后12月时患者最佳矫正视力〈0．05者1眼，0．05～0．3者6眼，0．3～0．5者8眼，≥0．5者13眼。术后1月与1周（P〈0．02）、3月与1月（P〈0．01）的视网膜神经上皮厚度＋脱离高度比较均有显著性差异，而术后6月、12月则无明显变化（P〉0．10）。结论光学相干断层扫描能从微观角度清晰地显示视网膜复位后黄斑区形态结构的变化，并能较好地解释术后视力的恢复过程，从而为科学预测术后视力提供帮助。Objective To observe macular images in patients undergoing retinal reattachment surgery with optical coherence tomography （OCT） and to investigate the relation between OCT images and visual recovery. Methods Twenty-eight patients （28 eyes） with uncomplicated rhegmatogenous retinal detachment involved in mactda undergoing retinal reattachmerit surgery were collected, and cross-sectional images of macula with OCT at 1 week, 1 month, 3 months,6 months, 12 months after the operation were observed and the relationships between images with visual recovery were evaluated. Results All eyes had subretinal fluid to different extent 1 week after surgery, and subretinal fluid decreased gradually with the time going on. Twelve months after surgery, there were 3 eyes with little subretinal fluid and the best corrected visual acuity was less than 0.05 in 1 eye,0.05-0.3 in 6 eyes,0.3-0.5 in 8 eyes,0.5 or better in 13 eyes. The visual acuity improved with the subretinal fluid absorption. There were significantly difference in retinal thickness ＋ datchment thickness between l week and l month （P〈0.01）,l month and 3 months（P〈0.01 ）after operation. But there was no significantly alteration of retinal thickness ＋ detchment thickness in 6 months, 12 months （P 〉 0.10） compared with 3 months after operation. Conclusion OCT can be used to observe macular Images alteration and to predict visual recovery after rhegmatogenous retinal detachment surgery.

关 键 词：光学相干断层扫描成像 视网膜脱离 视力 

分 类 号：R774.1[医药卫生—眼科]