非黄斑裂孔性视网膜脱离术后黄斑区血流及结构的改变分析  

Correlation analysis of macular blood flow and structure changes and visual acuity after non-macular hole retinal detachment surgery

作　　者：曾思雨 杜磊[1] 邢怡桥[1] Zeng Siyu;Du Lei;Xing Yiqiao(Department of 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,武汉430060

出　　处：《临床眼科杂志》2021年第2期102-105,共4页Journal of Clinical Ophthalmology

摘　　要：目的探讨非黄斑裂孔性视网膜脱离患者行玻璃体切除术(PPV)后黄斑区血流及结构改变。方法收集2019年1月至2020年1月于本院确诊视网膜脱离的患者36例(36只眼)纳入研究(PPV组),患者的对侧眼作为对照组。PPV组术后1周、1个月、3个月、6个月及对照组均进行最佳矫正视力(BCVA)和相干光层析血管成像术(OCTA)检查。观察PPV组术后各个时期视网膜全层厚度(FT)、椭圆体带断裂、浅层视网膜血流密度(SVD)、深层视网膜血流密度(DVD)等变化情况并与对照组比较差异。结果PPV组患者术后BCVA随着时间延长逐渐改善,在术后各时期,椭圆体带断裂者BCVA均较椭圆体完整者差(均P<0.05)。与对照组相比,PPV组患者术后1周时均发生不同程度的黄斑水肿,FT显著增加,而SVD、DVD显著降低(均P<0.05);术后1个月到术后6个月,FT、SVD及DVD随时间延长逐渐增加,术后6个月时FT恢复正常(P>0.05),SVD、DVD仍低于对照组(均P<0.05)。结论非黄斑裂孔性视网膜脱离的患者即使手术成功修复,术后也有可能发生椭圆体带断裂、视网膜血流灌注减少,观察术后黄斑区血流及结构的动态改变,可为将来实施改善视功能的干预治疗提供临床参考。Objective To investigate the correlation between the changes of macular vessel density and structure and visual acuity after pars plana vitrectomy(PPV)in patients with non-macular hole retinal detachment.Methods A total of 36 patients(36 eyes)with retinal detachment diagnosed at our hospital and received PPV(PPV group)from January 2019 to January 2020 were recruited,and the contralateral eye of the patients was included as the control group.The best corrected visual acuity(BCVA)and optical coherence tomography angiography(OCTA)examination were performed at 1 week,1 month,3 months and 6 months after the operation in both groups.The changes in retinal full thickness(FT),fracture of ellipsoid zone,superficial vessel density(SVD)and deep vessel density(DVD)in the PPV group were observed and compared with those in the control group.The correlations between FT,ellipsoid zone,SVD,DVD and BCVA were analyzed.Results The postoperative BCVA in the PPV group gradually improved over time.At all postoperative visits,BCVA of the patients with fractured ellipsoid zone was worse than that of patients with intact ellipsoid zone(all P<0.05).Compared with the control group,patients in the PPV group developed different degrees of macular edema,FT significantly increased,while SVD and DVD significantly decreased(all P<0.05)at 1 week after the surgery.FT,SVD and DVD gradually increased from 1 month to 6 months after the surgery.FT returned to normal(P>0.05),SVD and DVD were still lower than those in the control group(all P<0.05)at 6 months after the surgery.There was no significant correlation between FT,SVD and BCVA at all postoperative visits(all P>0.05).There was no significant correlation between DVD and BCVA at 1 week,1 month and 3 months after the surgery(all P>0.05),but there was a significant negative association between DVD and BCVA at 6 months after the surgery(P<0.05).Conclusions It is possible that ellipsoid zone fractured and decreased blood perfusion could occur in patients with non-macular hole retinal detachment after s

关 键 词：视网膜脱离 椭圆体带 黄斑区血流密度 视力 

分 类 号：R47[医药卫生—护理学]