不同染色剂辅助内界膜剥除治疗IMH手术前后微视野的变化  

Comparison of microperimetry before and after internal limiting membrane peeling assisted by different staining agents in idiopathic macular hole

作　　者：冯超[1] 吴建华[1] 阎静[1] 徐冲[1] 

机构地区：[1]爱尔眼科医院集团武汉爱尔眼科医院,中国湖北省武汉市430060

出　　处：《国际眼科杂志》2014年第11期2025-2027,共3页International Eye Science

基　　金：2012年度武汉市卫生局临床医学科研项目(No.WX12C53)~~

摘　　要：目的:观察研究应用不同染色剂辅助内界膜剥除治疗特发性黄斑裂孔(idiopathic macular hole,IMH)手术治疗前后黄斑区微视野的变化情况。方法:回顾性对比分析50例50眼特发性黄斑裂孔患者应用曲安奈德(triamcinolone acetonide,TA)或吲哚青绿(indocyanine green,ICG)辅助内界膜剥除治疗前后黄斑裂孔的闭合情况、最佳矫正视力以及微视野的改变。结果:术后随访6mo,经光学相干断层扫描(optical coherence tomography,OCT)检查TA组黄斑裂孔完全闭合76%、未闭合但裂孔平复16%、未闭合8%;ICG组黄斑裂孔完全闭合72%、未闭合但裂孔平复16%、未闭合12%,两组患者手术治疗后最佳矫正视力(best corrected visual acuity,BCVA)均明显改善但两组间比较差异无统计学意义,两组患者中央20°范围内黄斑微视野视网膜敏感度得到明显提高,TA组较ICG组更为明显。结论:玻璃体切割联合内界膜剥除术可有效的促进特发性黄斑裂孔的闭合、明显改善黄斑区视网膜敏感度以及视力。黄斑区微视野检查可以较好的随访评价IMH手术治疗后黄斑区视功能变化情况。AIM： To evaluate preoperative and postoperative the characteristics of microperimetry in patients who underwent macular surgery for idiopathic macular hole （ IMH） . METHODS： Fifty eyes of 50 patients with IMH were included in the study. Patients underwent pars plana vitrectomy and peeling of the internal limiting membrane （ ILM ）. ILM visualization was improved by using triamcinolone acetonide （TA group） or indocyanine green dye （ICG group）. Macular hole closure and retinal function was assessed preoperatively and postoperatively over a period of 6mo by spectraldomain optical coherence tomography examination, best corrected visual acuity （BCVA） and MP-1 microperimetry. RESULTS： Macular hole closure was achieved in 76%, Hole was not closed but calm in 16%, 8% was not closed in TA group and those in ICG group were 72%, 16% and 12% respectively, detected by optical coherence tomography （OCT）. At 6mo, visual acuity improved in both groups （P〈 0.05）, and there were no statistically significant differences of BCVA between groups. Mean macular sensitivity within the central 20% increased in both groups, and TA group＇s mean macular sensitivity wasbetter than ICG group＇s. CONCLUSIONVitrectomy and ILM peeling assisted with either TA or infracyanine green staining improves visual acuity and mean macular sensitivity at 6mo in patients affected by IMH. Macular microperimetry could be used to evaluation visual function changes of macular after surgery.

关 键 词：特发性黄斑裂孔 微视野 玻璃体切割 

分 类 号：R779.6[医药卫生—眼科]