不同染色剂辅助内界膜剥除治疗特发性黄斑裂孔手术前后自发荧光变化的临床观察  

Assessment of fundus autofluorescence before and after idiopathic macular hole surgery

作　　者：冯超[1] 吴建华[1] 闫涛[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,湖北武汉430060

出　　处：《中国实用眼科杂志》2015年第10期1087-1091,共5页Chinese Journal of Practical Ophthalmology

基　　金：2012年度武汉市卫生局临床医学科研项目（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）手术治疗前后眼底自发荧光（autofluorescence，AF）的变化情况。方法回顾性临床病例对比分析研究。对2012年8月至2013年10月在武汉爱尔眼科医院就诊的50例（50只眼）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AF强度的改变。结果术后随访6个月，经光相干断层扫描（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％，最佳矫正视力（BCVA）明显改善，差异有统计学意义（P〈0．05），TA组和ICG组患者中心凹、旁中心凹AF的强度明显降低。结论玻离体切割联合内界膜剥除术可以有效促进特发性黄斑裂孔的闭合、改善视力。AF检查在辅助BCVA随访评价IMH手术治疗前后视网膜功能的变化以及手术治疗的效果中有较好的作用，黄斑区自发荧光可做为其随诊的临床评价指标。Objective To evaluate preoperative and postoperative the characteristics of fundus au- tofluorescence in patients who underwent macular surgery for idiopathic macular hole. Methods Fifty patients （50 eyes） with idiopathic macular hole （IMH） were included in the study. Patients un- der-went pars plana vitrectomy and peeling of the internal limiting membrane （ILM）. ILM visualization was improved in 25 patients by using triamcinolone acetonide and in the remaining 25 patients by using indocyanine green dye. Spectral-domain optical coherence tomography examination was performed to document macular hole closure. Retinal function and characteristics of fundus autofluorescence was assessed preoperatively and postoperatively over a period of 6 months. Results Macular hole closure was achieved in almost all patients in both groups. At 6 months, visual acuity improved in both groups （P 〈0.05）, and there were no statistically significant differences between groups. The AF intensity at fovea and parafovea areas significantly decreased in all patients. Conclusions Vitrectomy and ILM peeling assisted with either triamcinolone acetonide or indocyanine green staining improves visual acuity at 6 months in patients affected by idiopathic macular hole. Fundus autofluorecence can be used as a follow up parameter for patients with IMH.

关 键 词：特发性黄斑裂孔 自发荧光 玻璃体切割 

分 类 号：R774.5[医药卫生—眼科]