微视野联合OCTA分析特发性黄斑前膜术后视功能的研究  

Study on the visual function with microperimeter and OCTA after idiopathic macular epiretinal membrane surgery

作　　者：葛慧敏 蒋沁[1] 徐向忠[1] Ge Huimin;Jiang Qin;Xu Xiangzhong(The Affiliated Eye Hospital of Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学附属眼科医院,南京210000

出　　处：《中华眼外伤职业眼病杂志》2021年第11期812-818,共7页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：国家自然科学基金(82070983)。

摘　　要：目的观察特发性黄斑前膜(IMEM)手术后微视野联合OCTA分析视功能情况。方法回顾性分析南京医科大学附属眼科医院2019年10月至2020年11月IMEM 42例(46只眼)的临床资料,患者均行25 G玻璃体切除联合黄斑前膜剥除手术,术后进行微视野计及光学相干断层扫描血管成像(OCTA)等检查并加以分析。随访1个月。结果术后1个月,视力(logMAR,BCVA)较术前明显提高(t=5.056,P<0.001);黄斑中心区厚度(CMT)较术前明显减小(t=7.766,P<0.001)。微视野联合OCTA结果显示:视网膜敏感度阈值、2°注视率及4°注视率均较术前明显增加(t=-7.500,-6.577,-7.759;均P<0.001);由注视点组成的63%二元轮廓椭圆面积和95%二元轮廓椭圆面积均较术前明显减小(t=5.414,8.615;均P<0.001);黄斑中心区浅层和深层视网膜血管密度、围绕黄斑中心凹血管密度值与术前相似(t=-0.089,-1.717,-1.552;P=0.929,0.093,0.128),但面积较术前增加(t=-2.257,P=0.029)。结论玻璃体切除联合黄斑前膜剥除术后通过微视野联合OCTA评估能有效提高IMEM患者的视功能。Objective To observe the visual function with microperimeter and OCTA after peeling of idiopathic macular epiretinal membrane(IMEM).Methods This was a retrospective study.The clinical data of 46 eyes of 42 patients with IMEM in the Affiliated Eye Hospital of Nanjing Medical University from Oct.2019 to Nov.2020 were recruited in the study.All patients underwent 25 G vitrectomy and macular epiretinal membrane peeling.The microperimetry and optical coherence tomography angiography(OCTA)after operation were examined and analyzed.The follow-up time was one month.Results The visual acuity(logMAR,BCVA)at 1 month postoperatively was improved compared with preoperation(t=5.056,P<0.001).The central macular thickness(CMT)were significantly decreased at 1 month postoperatively(t=7.766,P<0.001).The results of microperimeter and OCTA showed postoperative retinal average threshold,2°and 4°fixation indexes at 1 month postoperatively were all significantly increased compared with preoperation(t=-7.500,-6.577,-7.759;all P<0.001).Binary contour ellipse area for 63%and 95%of points were significantly decreased compared with those before operation(t=5.414,8.615;all P<0.001).There was no significant change in the superficial and deep macular vascular density within 3 mm×3 mm area,nor on the macular foveal vascular density within 300μm area around foveal avascular zone(FAZ)(FD-300)at 1 month after surgery(t=-0.089,-1.717,-1.552;P=0.929,0.093,0.128).However,FAZ area was increased(t=-2.257,P=0.029).Conclusion After IMEM peeling and vitrectomy,the visual function with microperimeter and OCTA can effectively improve in IMEM patients.

关 键 词：视网膜外膜 黄斑 体层摄影术 光学相干 视敏度 微视野计 染色 免疫组织化学 

分 类 号：R779.6[医药卫生—眼科]