频域光相干断层扫描视网膜脱离术后黄斑改变  

Analysis of macular changes after retinal detachment surgery by using spectral domain OCT

作　　者：杨煜生 杨天舒 王伟 杨正印 

机构地区：[1]南阳市眼科医院,河南473000

出　　处：《中华眼外伤职业眼病杂志》2014年第10期786-788,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的 分析累及黄斑区的孔源性视网膜脱离巩膜外垫压术后黄斑区形态改变。方法 累及黄斑的孔源性视网膜脱离43例，经间接检眼镜下巩膜扣带术和（或）联合环扎术后，视网膜解剖复位。分别于术后1周、1月、3月、6月复查视力、眼底检查和频域OCT检查并统计分析。结果 术后1周时，最佳矫正视力0．05～0．3，较术前提高（P=0．015）；OCT显示黄斑区视网膜下液完全吸收者占11．6％，好转者占44．2％，与术前相比差异有统计学意义（P：0．008）。术后3个月时，最佳矫正视力0．3～0．6，提高2行以上者占76．7％。术后12个月最佳矫正视力0．3—1．0，提高2行以上者占93．0％，与术后3个月时相比差异有统计学意义（P=0．025），与术后6个月时相比差异无统计学意义（P=0．24），黄斑区视网膜下液完全吸收者占90．7％，与术后6个月时相比差异有统计学意义（P=0．0018）。结论 频域OCT检查能够发现临床眼底检查不能发现的黄斑区神经上皮脱离的存在，黄斑区视网膜光感受器内外节连接结构连续性中断，进而为预测累及黄斑区的孔源性视网膜脱离术后视力恢复进程及病情解释提供依据。Objective To investigate macular changes of macular-involved rhegmatogenous retinal detachment（RD） after retinal reattachment surgery. Methods 43 patients with macular-involved rhegmatogenous retinal detachment（RD） underwent scleral buckling through the indirect ophthalmoscope. The retina of all patients was reattached anatomically. The best corrected visual acuity（BCVA） ,fundus examination and spectral-domain optical coherence tomography（SD-OCT） were reviewed at t week, 1 month,3 months and 6 months after surgery. Results One week after surgery, the BCVA was 0.05-0.3, which was improved comparing with preoperative BCVA （P = 0. 015）. The OCT showed the patients with subfoveal fluid completely absorbed, accounted for 11.6%. The patients with subfoveal fluid partly absorbed, accounted for 44.2%. And the difference had statistical significance compared with the preoperative one （P = 0. 008 ）. Three months after surgery, the BCVA was 0.3 - 0.6. And the patients with BCVA improved by 2 rows accounted for 76.7%. Twelve months after surgery, the BCVA was 0.3 - 1. O. The patients with BCVA improved by 2 rows accounted for 93.0%. The difference had statistical significance between the BCVA 3 months after surgery and the BCVA 6 months after surgery （P = 0. 025 ）. The patients with subfoveal fluid completely absorbed accounted for 90.7%, and the difference had statistical significance compared with that 6 months after surgery（P = 0. 0018）. Conclusion SD-OCT examination can detect the subclinical foveal detachment, and provide a reliable support for the prediction of visual acuity after rhegmatogenous retinal detachment surgery.

关 键 词：光学相干断层扫描 频域 视网膜脱离 孔源性 巩膜扣带术 改变 黄斑区 

分 类 号：R779.6[医药卫生—眼科]