玻璃体切割术对增生性糖尿病视网膜病变患者黄斑区视网膜的影响  

Effects of vitrectomy on macular retina of patients with proliferative diabetic retinopathy

作　　者：蒋乐文[1] 曹燕[1] 

机构地区：[1]河南能源焦作煤业集团中央医院眼科,河南省焦作市454000

出　　处：《眼科新进展》2014年第7期672-675,共4页Recent Advances in Ophthalmology

摘　　要：目的观察和分析玻璃体切割术对增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者黄斑区视网膜的影响。方法选取2010年6月至2012年6月我院收治的40例(54眼)PDRⅤ期患者作为观察组,同时选取40例(54眼)正常志愿者作为对照组。观察组患者均应用标准三切口玻璃体切割术联合超声乳化人工晶状体植入术进行治疗。两组均行裂隙灯、验光、眼压、眼底等常规眼部检查,利用光学相干断层扫描(optical coherence tomography,OCT)检查黄斑区视网膜厚度,同时利用多焦视网膜电图(multifocal electroretinogram,mf-ERG)检查P1波、N1波5环、4个象限(鼻上象限、鼻下象限、颞下象限、颞上象限)的振幅密度及潜伏期等。结果观察组患眼术前、术后黄斑中心凹视网膜厚度分别为(352.9±127.6)μm和(263.8±27.3)μm,对照组黄斑中心凹视网膜厚度为(137.6±18.5)μm,观察组患眼术后的黄斑中心凹视网膜厚度较术前显著降低,差异均有统计学意义(P<0.05),但均显著高于对照组,差异均有统计学意义(均为P<0.05)。观察组患眼的1环、2环、鼻上象限、鼻下象限的术后P1波振幅密度较术前显著提高,差异均有统计学意义(均为P<0.05),而3环、4环、5环、颞下象限、颞上象限的术后P1波振幅密度较术前显著降低,差异均有统计学意义(均为P<0.05)。观察组患眼术前和术后5环和颞上象限的P1波振幅密度显著低于对照组,差异均有统计学意义(均为P<0.05)。观察组术前1环的P1波潜伏期与对照组比较,差异无统计学意义(P>0.05);观察组术后3环、4环、5环的P1波潜伏期与对照组比较,差异均无统计学意义(均为P>0.05);观察组术后鼻下象限、颞下象限P1波潜伏期与对照组比较,差异均无统计学意义(均为P>0.05);其余组间两两比较,差异均有统计学意义(均为P<0.05)。观察组术后1环的N1波振幅与对照组比较,差异无统计学意义(P>0.05);除此之外,观Objective To observe and analyze the effects of vitrectomy on macular retina of the patients with proliferative diabetic retinopathy （PDR）. Methods Forty patients with PDR in stage V （54 affected eyes） in our hospital from June 2010 to June 2012 were selected as the observation group, while 40 normal subjects （54 examined eyes） were selected as the control group. All of the patients in the observation group were treated with the standard three port vitrectomy combined with phacoemulsification and intraocular lens implantation. The optical coherence tomography （OCT） and multifocal electroretinogram （mf-ERG） inspection were applied to the patients in the observation group before and after operation and the normal subjects in the control group. The macular retinal thickness and the amplitude densities and latencies of P1 wave, N1 wave at 5 rings and 4 quadrants （ upper nasal quadrant, lower nasal quadrant, lower temporal quadrant, upper temporal quadrant） were tested and compared. Results The postoperative foveal retinal thickness of the affected patients＇ eyes in the observation group （263.8 ± 27.3 ） μm decreased significantly compared with that before operation （ 352.9 ± 127.6 ） p.m （ P 〈 0.05 ）, but was significantly higher than that of the control group （ 137.6 ± 18.5 ） pore （P 〈0.05 ）. The postoperative P1 wave amplitude densities of the affected patients＇ eyes in the observation group at ring 1, ring2, upper nasal quadrant and lower nasal quadrant increased significantly compared with those before the operation （ all P 〈 0.05 ）, and those at ring 3, ring 4, ring 5, lower temporal quadrant, upper temporal quadrant decreased significantly compared with those before the operation （ all P 〈 0.05 ）, but the preoperative and postoperative P1 wave amplitude densities of the normal subjects＇ eyes in the observation group at 5 rings and 4 quadrants were significantly lower than those of the control group （ all P 〈 0.05 ）. The postoperative N1 w

关 键 词：增生性糖尿病视网膜病变 玻璃体切割术 多焦视网膜电图 光学相干断层扫描 

分 类 号：R774.1[医药卫生—眼科]