频域相干光断层扫描观察特发性黄斑裂孔患者手术前后光感受器细胞层改变  

Recovery of photoreceptor inner/outer segment junction in spectral domain optical coherence tomography after surgery in idiopathic macular hole

作　　者：贺峰[1] 于伟泓[1] 戴荣平[1] 张枝桥[1] 董方田[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院眼科,100730

出　　处：《中华眼科杂志》2011年第6期504-507,共4页Chinese Journal of Ophthalmology

摘　　要：目的探讨特发性黄斑裂孔患者手术前后光感受器细胞层内外节的改变特征。方法回顾性病例系列研究。收集32例（32只眼）确诊并接受手术治疗的特发性黄斑裂孔患者的临床资料进行回顾性分析，同时对其手术前后的高分辨率频域相干光断层扫描（OCT）图像进行对比研究。患者手术前与后logMAR视力和光感受器细胞层内外节被破坏区域直径比较，采用配对t检验；手术前黄斑裂孔直径和光感受器细胞层内外节被破坏区域直径与术后logMAR视力比较，采用Bivariate过程的Pearson相关分析法。结果32例（32只眼）患者的logMAR视力为0．40—2．00，平均1．16±0．46；黄斑裂孔直径332—1568μm，平均（859．7±292．0）μm；光感受器细胞层内外节被破坏区域直径867-3444μm，平均（1965．1±584．1）μm。手术后25只眼（78．1％）黄斑裂孔闭合，logMAR视力为0．30—2．00，平均0．89±0．46；光感受器细胞层内外节被破坏区域直径153—2546μm，平均（1350．4±642．6）μm；手术后患者病变修复和视力改善情况与手术前logMAR视力（t=3．384）和光感受器细胞层内外节被破坏区域直径（t=6．360）比较，差异均有统计学意义（P〈0．05）。患者手术前的黄斑裂孔直径（r=0．583）和光感受器细胞层内外节被破坏区域直径（r=0．416）与术后logMAR视力呈正相关（P〈0．05）。结论患者术前黄斑裂孔直径和光感受器细胞层内外节被破坏区域直径与术后视力呈正相关。接受手术治疗的患者其光感受器细胞层内外节被破坏区域明显缩小。Objective To evaluate the findings of spectral domain optical coherence tomography （SD-OCT） in patients with idiopathic macular hole （IMH）. Methods It was a retrospective case series study. Pre- and post-operative data from patients with IMH during 14 months were analyzed retrospectively. The main outcome data included logarithm of the minimal angle of resolution （logMAR） and SD-OCT findings, including the size of the IMH and the disruption of the boundary line between inner segments （IS） and outer segments （ OS ） of the photoreceptors. The data were analyzed using the statistical software SPSS14. 0. The correlation among various data was analyzed by Bivariate correlation. The pre-and post- operative data were compared by paired-samples t-tests. Results Thirty two eyes of 32 patients were studied. The mean IogMAR was 1.16 ± 0. 46 （ ranged from 0. 40 to 2. 00 ） , the mean diameter of macular hole was （859.7±292.0） μm （ranged from 332 to 1568 μm）. The mean diameter of IS/OS disruption was （1965.1±584. 1） μm （ranged from 867 to 3444μm）. In eyes after surgery, the mean logMAR was 0. 89 ±0. 46 （ranged from 0. 30 to 2.00）, the mean diameter of the IS/OS disruption was （1350. 4 ± 642.6） μm （ranged from 153 to 2546 p,m）, both were decreased significantly as compare with the preoperative data（ t = 3. 384,6. 360 ; P 〈 0.05 ）. Preoperative diameter of macular hole （ r = 0. 583 ） and IS/OS disruption （ r = 0. 416 ） were correlated significantly with postoperative logMAR （ P 〈 0.05 ） . Conclusions Preoperative diameter of maeular hole and IS/OS disruption play the main role in vision prognosis. The IS/OS disruption is decreased signifieantly after the operation.

关 键 词：视网膜穿孔 玻璃体切除术 体层摄影术 光学相干 光感受器 

分 类 号：R774.1[医药卫生—眼科]