特发性黄斑裂孔患眼黄斑中心凹脉络膜毛细血管层血流面积和椭圆体带缺损直径与视力恢复的相关性分析  

Correlation analysis of choriocapillary blood flow area,diameter of ellipsoid zone absence and visual recovery in idiopathic macular hole

作　　者：李思园 赵芃芃 秦梅[1] Li Siyuan;Zhao Pengpeng;Qin Mei(Department of Opthalmology,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院第一附属医院眼科,233000

出　　处：《中华眼底病杂志》2021年第2期127-132,共6页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察特发性黄斑裂孔(IMH)患者手术前后黄斑中心凹下脉络膜毛细血管层血流面积(CBFA)与椭圆体带缺损直径(DEZA)的变化,分析两者与视力恢复的相关性。方法前瞻性研究。2019年5月至2020年1月在蚌埠医学院第一附属医院眼科确诊为IMH并接受玻璃体视网膜手术治疗的23例患者23只眼(IMH患眼组)及其健康对侧眼23只(对侧眼组),以及年龄、性别与之匹配的正常健康者30名30只眼(正常对照组)纳入研究。手术前及手术后1、3、6个月,所有受检眼均采用国际标准Snellen视力表检测最佳矫正视力(BCVA),统计分析时转换为最小分辨角对数(logMAR)视力记录。采用光相干断层扫描血管成像(OCTA)检测3组受检眼的CBFA、DEZA。CBFA:以中心凹为中心、半径1 mm圆形区域的视网膜色素上皮层下脉络膜毛细血管层血流面积。DEZA:水平方向上椭圆体带缺失区直径。对比分析3组受检眼手术前后CBFA及logMAR BCVA的差异以及IMH患眼组组内手术前后CBFA、DEZA、logMAR BCVA的变化。3组间计量资料比较采用单因素方差分析,两组间比较使用独立样本t检验。各观察指标之间的相关性采用Pearson相关性分析,手术后视力与基线各因素的相关性采用多元线性回归分析。结果手术前及手术后6个月,IMH患眼组logMAR BCVA分别为1.26±0.7、0.48±0.22,CBFA分别为(1.49±0.30)、(1.92±0.17)mm2,DEZA分别为(1080.22±576.98)、(433.78±423.04)μm。与手术前比较,手术后6个月IMH患眼组BCVA明显提高,CBFA明显增大,DEZA明显缩小,差异均有统计学意义(t=5.53、7.77、6.58,P<0.01)。IMH患眼组手术前CBFA小于对侧眼组、正常对照组(F=14.13,P<0.01);IMH患眼组手术后CBFA与对侧眼组无明显差异(t=4.32,P=0.37),但仍小于正常对照组(t=4.07,P<0.01)。Pearson相关性分析结果显示,手术前及手术后6个月的logMAR BCVA与DEZA呈正相关(r=0.69、0.75,P<0.01);手术前及手术后6个月的CBFA与DEZA呈负相关(r=-0.4Objective To observe the changes of choriocapillary blood flow area(CBFA)and diameter of ellipsoid zone absence(DEZA)of eyes with idiopathic macular hole(IMH)before and after surgery and its correlation with visual function.Methods A prospective study.From May 2019 to January 2020,23 IMH patients(IMH group and fellow eyes group)diagnosed in the Department of Opthalmology of The First Affiliated Hospital of Bengbu Medical College,and 30 age and gender-matched normal controls(30 eyes,control group)were included in this study.All patients were examined the best corrected visual acuity(BCVA)before and after surgery.The BCVA examination was performed using the international standard Snellen visual acuity chart,which was converted into logarithm of the minimum angle of resolution(logMAR)BCVA for record.CBFA and DEZA were obtained by optical coherence tomography angiography(OCTA).CBFA was measured on the choriocapillary with a circle of 1.0 mm radius centered in the fovea.DEZA was the diameter of ellipsoid zone absence horizontally.The differences of CBFA and logMAR BCVA in the three groups,and the changes of CBFA,DEZA,logMAR BCVA in IMH group before and after surgery were analyzed.The measurement data between the three groups were compared by one-way analysis of variance,and the independent samples t test was used for the comparison between the two groups.Pearson correlation analysis was used for the correlation between the index,multiple linear regression analysis were performed between postoperative visual acuity and preoperative parameters.Results Before and 6 months after surgery,the logMAR BCVA in IMH group were 1.26±0.7 and 0.48±0.22,CBFA were 1.49±0.30 and 1.92±0.17 mm2,DEZA were 1080.22±576.98 and 433.78±423.04μm,respectively.Compared with those before surgery,BCVA and CBFA were significantly improved,DEZA obviously decreased and the differences were statistically significant(t=5.53,7.77,6.58;P<0.01).CBFA in IMH group was lower than fellow eyes group and control group,the difference was statistically sig

关 键 词：视网膜穿孔 局部血流 体层摄影术 光学相干 椭圆体带 

分 类 号：R779.6[医药卫生—眼科]