特发性黄斑裂孔患眼手术前后视力及固视性质分析  

Analysis of the properties of visual acuity and fixation in eyes with idiopathic macular hole before and after surgery

作　　者：陈思文 王海林[2] 牛彤彤[2] Chen Siwen;Wang Hailin;Niu Tongtong(Graduate Student Training Base,The Fourth People's Hospital of Shenyang,Jinzhou Medical University,Shenyang 110031,China;Department of Ophthalmology,The Fourth People's Hospital of Shenyang,Shenyang 110031,China)

机构地区：[1]锦州医科大学沈阳市第四人民医院研究生培养基地,沈阳110031 [2]沈阳市第四人民医院眼科,沈阳110031

出　　处：《中华眼底病杂志》2022年第10期811-817,共7页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察特发性黄斑裂孔(IMH)患眼手术前后视力及固视性质变化。方法前瞻性临床研究。2019年9月至2020年12月于沈阳市第四人民医院眼科检查确诊的IMH患者25例25只眼纳入研究。所有患眼均行玻璃体切割手术(PPV)联合内界膜剥除治疗。手术前后所有患眼均行最佳矫正视力(BCVA)、光相干断层扫描(OCT)、微视野检查。BCVA检查采用Snellen视力表进行,统计时换算为最小分辨角对数(logMAR)视力。采用MP-3微视野计测量患眼黄斑12°视网膜光敏感度(MS)、双变量轮廓椭圆面积(BCEA)。采用OCT仪测量患眼黄斑裂孔最小直径(MIN)、基底直径(BASE);应用Image-proplus 6.0图像处理软件测量优选的视网膜注视点(PRL)与黄斑中心凹中心距离。手术后随访1、3个月时采用手术前相同设备和方法行相关检查。对比观察患眼手术前后BCVA、PRL距离黄斑中心凹距离、MS、BCEA、黄斑裂孔形态的变化。手术前后各指标比较采用单因素方差分析;手术后3个月BCVA与手术前BCVA、PRL与黄斑中心凹中心距离的相关性采用Pearson相关性分析;手术前MIN、BCVA、PRL与黄斑中心凹中心距离、MS、BCEA与手术后3个月BCVA的相关性行多元线性回归分析。结果25例25只眼中,男性1例1只眼,女性24例24只眼;黄斑裂孔分期为Ⅲ、Ⅳ期分别为11、14只眼。MIN、BASE分别为(537.68±200.09)、(905.48±278.79)μm。手术后1个月,裂孔均闭合。手术前及手术后1、3个月,患眼logMAR BCVA分别为0.80±0.17、0.70±0.21、0.60±0.25,MS分别为(22.20±3.86)、(23.60±3.14)、(24.38±2.68)dB,PRL与黄斑中心凹中心距离分别为(537.72±426.05)、(402.00±395.06)、(236.80±219.54)μm,BCEA分别为(7.90±3.43)、(6.40±2.67)、(4.80±2.32)deg2。与手术前比较,手术后不同时间BCVA(F=7.047、20.104)、MS(F=1.980、5.390)明显提高,PRL与黄斑中心凹中心距离(F=1.265、9.530)、BCEA(F=2.762、13.617)缩小,差异均有统计学意义(P<0.05)。相关�Objective To observe the changes of visual acuity and fixation properties of eyes with idiopathic macular hole(IMH)before and after surgery.Methods A prospective clinical study.From September 2019 to December 2020,25 patients with 25 eyes of IMH diagnosed in Department of Ophthalmology of The Fourth People's Hospital of Shenyang were included in the study.All patients underwent pars plana vitrectomy(PPV)combined with internal limiting membrane stripping.All eyes underwent best corrected visual acuity(BCVA),optical coherence tomography(OCT),and microperimetry before and after surgery.The BCVA examination was carried out using the Snellen visual acuity chart,which was converted into logarithmic minimum resolution angle(logMAR)visual acuity during statistics.The 12°macular sensitivity(MS)and bivariate contour ellipse area(BCEA)were measured by MP-3 microperimetry.The minimum diameter(MIN)and base diameter(BASE)of the macular hole were measured by OCT;the distance between the preferred retinal location(PRL)and the center of the fovea was measured by Image-proplus 6.0 image processing software.At 1 and 3 months follow-up after surgery,the same equipment and methods as before surgery were used to conduct related examinations.The changes of BCVA,PRL distance from the fovea,MS,BCEA,and macular hole shape before and after surgery were compared and observed.One-way analysis of variance was used to compare the indicators before and after surgery.Pearson correlation analysis was used for the correlation between BCVA and preoperative BCVA,PRL and foveal center distance at 3 months after surgery.The correlation between MIN,BCVA,PRL and foveal center before surgery distance,MS,BCEA and BCVA at 3 months after surgery were analyzed by multiple linear regression.Results Among 25 eyes of 25 cases,1 male had 1 eye,and 24 females had 24 eyes.The macular hole in stageⅢandⅣwere 11 eyes and 14 eyes,respectively.MIN and BASE were 537.68±200.09 and 905.48±278.79μm,respectively.One month after surgery,the hiatus was closed.Before s

关 键 词：特发性黄斑裂孔 玻璃体视网膜手术 视力 固视性质 视野测试 体层摄影术 光学相干 

分 类 号：R779.6[医药卫生—眼科]