脉络膜脱离型视网膜脱离术后黄斑中心凹下脉络膜厚度的变化  

Alterations in Subfoveal Choroidal Thickness after Pars Plana Vitrectomy in Rhegmatogenous Retinal Detachment Associated with Choroidal Detachment

作　　者：冯超[1] 邢怡桥[1] Chao Feng;Yiqiao Xing(Eye Center,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院眼科中心,430060

出　　处：《中华眼视光学与视觉科学杂志》2018年第11期683-687,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:观察脉络膜脱离型视网膜脱离(RRDCD)患者接受玻璃体切割(PPV)复位视网膜后硅油填充状态下黄斑中心凹下脉络膜厚度(SCT)的变化。方法:回顾性病例对照研究。2016年1月至2017年10月在武汉大学人民医院眼科中心就诊的35例首次接受PPV成功复位视网膜的RRDCD患者纳入研究(作为RRDCD组)。记录患者术后1d、1周、1个月、3个月的最佳矫正视力(BCVA)(LogMAR)、眼压,采用光学相干断层扫描(OCT)测量SCT。36例首次接受PPV成功复位视网膜的单纯孔源性视网膜脱离(RRD)患者作为RRD组及40例医院的体检者作为正常组。数据采用秩和检验(H检验)、重复测量方差分析、独立样本t检验、卡方检验等进行分析。结果:术后1d、1周,RRDCD组、RRD组SCT均较正常组厚(术后1d:t=9.220,P<0.001;t=6.826,P<0.001。术后1周:t=4.341,P=0.011;t=2.849,P=0.034),而这2个时间点RRDCD组和RRD组间的SCT差异无统计学意义。术后3个月,RRD组SCT与正常组比较差异无统计学意义(t=1.597,P=0.646),而RRDCD组SCT相对正常组及RRD组都要薄,差异有统计学意义(t=-3.144,P=0.028;t=-6.207,P=0.010)。术后RRDCD组和RRD组SCT均呈持续降低趋势。相关性分析显示术后3个月,RRDCD组SCT与BCVA呈正相关(r=0.399,P=0.017),RRD组SCT与BCVA无相关性(r=0.109,P=0.529)。结论:RRDCD术后黄斑SCT变薄,且SCT与BCVA相关。SCT可以作为评估RRDCD术后视力的临床指标。Objective:To observe the changes in subfoveal choroidal thickness after pars plana vitrectomy(PPV)in patients with rhegmatogenous retinal detachment associated with choroidal detachment(RRDCD).Methods:This was a retrospective case control study.Thirty-five RRDCD patients whose retinas had been reset successfully after a single operation in the Eye Center,Renmin Hospital of Wuhan University from January 2016 to October 2017 were included in the study.The best corrected visual acuity(BCVA),intraocular pressure(IOP)and subfoveal choroidal thickness(SCT)were measured by optical coherence tomography(OCT)and recorded at 1 day,1 week,1 month and 3 months after the operation.Thirty-six patients with rhegmatogenous retinal detachment(RRD)whose retinas had been successfully reset served as the experimental control group and 40 patients from a normal population served as normal control group.Results:One day and 1 week after surgery,the SCTs in groups RRDCD and RRD were thicker than that of normal control group(1 day:t=9.220,P<0.001;t=6.826,P<0.001.1 week:t=4.341,P=0.011;t=2.849,P=0.034),but there were no significant differences between the two groups overall.Three months after the operation,there was no significant difference in the SCT between the RRD group and the normal group(t=1.597,P=0.646),while the SCT in group RRDCD was thinner than that of both the normal and RRD groups(t=-3.144,P=0.028;t=-6.207,P=0.010).Correlation analysis showed that there was a positive correlation between SCT and BCVA in group RRDCD at 3 months after the operation(r=0.399,P=0.017).There was no significant correlation between SCT and BCVA in group RRD at 3 months after the operation(r=0.109,P=0.529).Conclusions:SCT become to be thin,and is related to BCVA can be used as a clinical indicator for evaluating the therapeutic effect of RRDCD.

关 键 词：孔源性视网膜脱离 脉络膜脱离 脉络膜厚度 

分 类 号：R779.6[医药卫生—眼科]