黄斑裂孔面积相关参数在预测特发性黄斑裂孔患者术后裂孔闭合形态中的应用  

Clinical study of new method to predict the postoperative closure type of idiopathic macular hole

作　　者：赵抒羽[1] 何锦贤[1] 梁先军 ZHAO Shuyu;HE Jinxian;LIANG Xianjun(Foshan Aier Eye Hospital,Foshan 528000,Guangdong Province,China;Aier School of Ophthalmology,Central South University,Changsha 410015,Hunan Province,China)

机构地区：[1]佛山爱尔眼科医院,广东省佛山市528000 [2]中南大学爱尔眼科学院,湖南省长沙市410015

出　　处：《眼科新进展》2021年第8期770-773,共4页Recent Advances in Ophthalmology

基　　金：广东省佛山市卫生和计生局科研课题(编号20190183)。

摘　　要：目的应用黄斑裂孔面积相关参数预测特发性黄斑裂孔(IMH)患者术后裂孔闭合形态的有效性。方法将2018年6月至2020年12月因IMH行玻璃体切割联合内界膜剥除术患者共47例47眼纳入本研究。所有患者均行最佳矫正视力(BCVA)、频域光学相干断层扫描(SD-OCT)检查。将黄斑裂孔闭合形态分为1型及2型。计算黄斑裂孔指数(MHI)、裂孔直径指数(DHI)、黄斑裂孔愈合指数(MHCI)和裂孔形成因子(HFF)。采用ImageJ软件获得以下参数裂孔两侧外界膜断端到光感受器脱离起点的曲线距离(m、n)、黄斑裂孔面积(MHA)、裂孔区视网膜面积(MHTA)、囊腔面积(MHCSA)。计算裂孔面积指数(MHAI)、裂孔区视网膜面积指数(MHTAI)、囊腔面积指数(MHCSAI)。术前与术后3个月患者BCVA行非参数秩和检验;将患者各评估参数、术后视力与裂孔闭合形态行Spearman相关性分析;术前各种黄斑裂孔评估参数进行受试者工作特征(ROC)曲线分析。结果1型黄斑裂孔闭合患者术前BCVA与术后3个月比较差异有统计学意义(P<0.001);2型黄斑裂孔闭合患者术前BCVA与术后3个月比较差异无统计学意义(P=0.09)。IMH患者黄斑裂孔闭合形态与术后BCVA(r=0.57,P=0.0003)、MHI(r=-0.64,P<0.0001)、MHCI(r=-0.67,P<0.0001)、HFF(r=-0.66,P<0.0001)、MHAI(r=0.70,P<0.0001)均呈显著相关;与MHTAI(r=-0.48,P=0.04)、MHSCAI(r=-0.49,P=0.04)均呈弱相关;与DHI(r=0.35,P=0.42)无相关性。MHI、DHI、HFF、MHCI、MHAI、MHTAI、MHCSAI的AUC分别为0.921、0.720、0.929、0.944、0.957、0.803、0.806,其cut-off值分别为>0.35、>0.56、<0.56、>0.84、>0.33、<0.39、<0.23。结论运用ImageJ软件对IMH患者的SD-OCT结果进行分析发现,MHAI、MHCI是预测黄斑裂孔患者术后裂孔闭合形态的最重要指标。Objective To predict the effectiveness of the postoperative closure type of idiopathic macular hole(IMH)using the IMH area and other related parameters.Methods A total of 47 IMH patients(47 eyes)who had undergone pars plana vitrectomy(PPV)and internal limiting membrane peeling(ILMP)from June 2018 to December 2020 were selected in the study.The best corrected visual acuity(BCVA)and spectral domain optical coherence tomography(SD-OCT)were performed for all patients.The macular hole closure was classified into type 1 and type 2.The macular hole index(MHI),diameter hole index(DHI),macular hole closure index(MHCI)and hole form factor(HFF)were calculated.The Image J software was used to obtain the following parameters the curvilinear distance(m,n)from the broken end of the outer limiting membrane on both sides of the hole to the starting point of photoreceptor detachment,macular hole area(MHA),macular hole retinal area(MHTA),and macular hole cystoid space area(MHCSA).The macular hole area index(MHAI),macular hole retinal area index(MHTAI),and macular hole cystoid space area index(MHCSAI)were calculated.The non-parametric rank sum test was performed for the BCVA preoperatively and three months postoperatively.The Spearman correlation analysis was performed between the evaluation parameters,postoperative visual acuity and MH closure type.The receiver operating characteristic(ROC)curve analysis was performed for preoperative MH evaluation parameters.Results The BCVA of patients with type 1 macular hole closure showed statistically significant difference preoperatively and three months postoperatively(P<0.001),while the BCVA of patients with type 2 macular hole closure showed no statistically significant difference(P=0.09).The macular hole closure type was significantly correlated with the postoperative BCVA(r=0.57,P=0.0003),MHI(r=-0.64,P<0.0001),MHCI(r=-0.67,P<0.0001),HFF(r=-0.66,P<0.0001),MHAI(r=0.70,P<0.0001),and weakly correlated with the DHI(r=0.35,P=0.42),MHTAI(r=-0.482,P=0.04),and MHSCAI(r=-0.49,P=0.04).The AUC of M

关 键 词：特发性黄斑裂孔 频域光学相干断层扫描 愈合指数 面积指数 

分 类 号：R774[医药卫生—眼科]