特发性黄斑前膜在光学相干断层扫描上的形态学改变与视力的相关性  

Correlation between morphological changes on optical coherence tomography and visual acuity in idiopathic macular epiretinal membranes

作　　者：黄文龙 韦玉玲 雷蔚 许惠卓[2] HUANG Wenlong;WEI Yuling;LEI Wei;XU Huizhuo(Department of Ophthalmology,Liuzhou Red Cross Hospital,Liuzhou Guangxi 545001;Department of Ophthalmology,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]柳州市红十字会医院眼科,广西柳州545001 [2]中南大学湘雅医院眼科,长沙410008

出　　处：《眼科学报》2021年第12期977-983,共7页Eye Science

摘　　要：目的:探究特发性黄斑前膜(idiopathic macular epiretinal membrane,IMEM)患者在光学相干断层扫描(optical coherence tomography,OCT)的形态学改变与视力的相关性。方法:回顾性研究。基于OCT图像4级分级方案,纳入3级及以下的特发性黄斑前膜患者35例共37只眼进行OCT扫描,并借助第三方软件分析并获取每只眼在黄斑中心凹直径分别为1、3、6 mm共3个同心圆区域内视网膜各层的平均厚度值,并按照是否存在内核层(inner nuclear layer,INL)囊样改变分为两组。通过建立最小分辨角对数(minimum resolution angle in logarithmic,logMAR)最佳矫正视力(best corrected vision acuity,BCVA)与视网膜各层厚度值的多元线性回归方程,以及比较有INL囊样改变及无INL囊样改变两组的视力,分析视力与视网膜各层厚度值及INL囊样改变的关系。结果:多元线性回归分析显示,在直径1 mm的区域内,logMAR BCVA与神经纤维层(retina nerve fiber layer,RNFL)、INL的厚度值均呈正相关(均P<0.05),而在直径3 mm和6 mm的区域内,logMAR BCVA仅与INL的厚度值呈正相关(均P<0.05)。与无INL囊样改变组相比,有INL囊样改变组视力及INL厚度差异均有统计学意义(均P<0.05)。结论:特发性黄斑前膜患者当前的视力主要与RNFL和INL厚度值相关。发生在INL层的囊样改变可能很好的提示INL增厚,其与视力具有相关性,具有这种囊样改变的患者往往视力也较差。Objective:To investigate the morphological changes detected by spectral domain optical coherence tomography(OCT)and their relevance to vision in patients with idiopathic macular epiretinal membranes(IMEM).Methods:This is a retrospective study.OCT recorded 37 eyes with stage 3 and below IMEM according to the 4-level grading system based on OCT images among 35 patients.We managed to obtain thickness of all retina layers in three concentric circular regions with a diameter of 1 mm,3 mm and 6 mm across macular fovea with the help of a third-party software.Plus we divided all 37 eyes into two groups according to whether there were cystic changes in the inner nuclear layer(INL).Multiple linear regression analyses were performed between thickness of all retina layers and current minimum resolution angle in logarithmic(logMAR)best corrected visual acuity(BCVA).The difference of BCVA between groups with cystic changes and without was also compared.Thus,the relationships between visual acuity and thickness of retina layers,cystic changes in INL were analyzed.Results:Multiple linear regression analyses revealed that thickness of both retina nerve fiber layer(RNFL)and inner nuclear layer have positive correlation with logMAR BCVA in the region with a diameter of 1 mm(P<0.05),while in regions of a diameter of 3 mm and 6 mm,only INL thickness remained positively relevant(all P<0.05).There were significant differences in BCVA and thickness of INL between groups with INL cystic changes and without(all P<0.05).Conclusion:Current visual acuity among preoperative IMEM patients was mostly associated with thickness of RNFL and INL.Cystic change in INL layer may be a good indicator of INL thickening and was visually correlated.Those with this change tend to have worse vision.

关 键 词：特发性黄斑前膜 光学相干断层成像 视网膜厚度 囊样改变 囊样水肿 

分 类 号：R774.5[医药卫生—眼科]