微视野检查在巨大黄斑孔治疗中的应用  

Application of microperimetry in the treatment of giant macular hole

作　　者：彭洁 王倩[1] 闫磐石[1] Peng Jie;Wang Qian;Yan Panshi(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2022年第5期332-337,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评估微视野检查在巨大黄斑孔治疗中的应用效果。方法回顾性病例系列研究。分析2019年10月至2021年9月郑州大学第一附属医院收治的巨大黄斑孔33例(33只眼)的临床资料。所有患者接受玻璃体切除联合超声乳化人工晶状体植入、内界膜剥离填塞及空气填充术。术前及术后行微视野检查、验光及OCT检查,观察中心凹视敏度、黄斑区视敏度、2°及4°注视稳定性。术后随访3个月。结果术前视力与中心凹及黄斑区视敏度均呈负相关(r=-0.78,-0.71;均P<0.001),与2°及4°注视稳定性不相关(r=-0.30,-0.16;P=0.130,0.520)。术前黄斑孔直径与中心凹及黄斑区视敏度均呈负相关(r=-0.79,-0.81;均P<0.001),与2°及4°注视稳定性不相关(r=-0.30,-0.26;P=0.190,0.270)。术后3个月的视力(BCVA,logMAR)、中心凹及黄斑区视敏度、2°及4°注视稳定性分别为0.74±0.17、(6.13±4.27)dB、(15.78±4.91)dB、(74.19±15.95)%、(89.95±2.09)%,较术前均有明显改善(t=7.05,-4.01,-3.80,-3.21,-3.39;P=0.001,0.001,0.001,0.011,0.008)。结论微视野检查可评估治疗巨大黄斑孔的效果,术前视力和黄斑孔直径均与中心区及黄斑区敏感度呈负相关。Objective To evaluate the application efficacy of microperimetry in the treatment of patients with giant macular hole.Methods This was a retrospective case series study.The clinical data of 33 eyes of 33 cases with giant macular hole treated from Oct.2019 to Sep.2021 in the First Affiliated Hospital of Zhengzhou University were analysed.All patients received vitrectomy combined with phacoemulsification and intraocular lens implantation,internal limiting membrane peeling and tamponade and air tamponade.Microperimetry,optometry and OCT were performed before and after operation.The central foveal sensitivity,macular sensitivity,2°and 4°fixation stability were observed.The follow-up time was 3 months after surgery.Results Preoperative visual acuity correlated negatively with central and macular sensitivity(r=-0.78,-0.71;all P<0.001)but not with 2°and 4°fixation stability(r=-0.30,-0.16;P=0.13,0.52).Preoperative macular hole diameter correlated negatively with central and macular sensitivity(r=-0.79,-0.81;all P<0.001),but not correlated with 2°and 4°fixation stability(r=-0.30,-0.26;P=0.190,0.270).The visual acuity(BCVA,logMAR),foveal and macular sensitivity,2°and 4°fixation stability were 0.74±0.17,(6.13±4.27)dB,(15.78±4.91)dB,(74.19±15.95)% and(89.90±2.09)%,which improved significantly compared with those before operation(t=7.05,-4.01,-3.80,-3.21,-3.39;P=0.001,0.001,0.001,0.011,0.008).Conclusion Microperimetry can be used to evaluate the efficacy of giant macular hole.Preoperative visual acuity and macular hole diameter are negatively correlated with central and macular sensitivity.

关 键 词：视网膜穿孔 微视野检查 超声乳化白内障吸除术 玻璃体切除术 视敏度 

分 类 号：R779.6[医药卫生—眼科]