内界膜剥离对糖尿病性黄斑前膜患者黄斑区血流信号的影响研究  

Influence of Internal Limiting Membrane Peeling on Macular Blood Flow in Patients with Diabetic Epimacular Membrane

作　　者：李博 苟文军[1] 解宸 游慧 白梦天 李恒[1] Li Bo;Gou Wenjun;Xie Chen(Suining Central Hospital Eye Center,Suining,Sichuan 629000,China)

机构地区：[1]遂宁市中心医院眼科中心,四川遂宁629000

出　　处：《四川医学》2022年第10期1008-1013,共6页Sichuan Medical Journal

摘　　要：目的探讨术中内界膜(ILM)剥离对糖尿病性黄斑前膜(ERM)患者黄斑区血流信号的影响。方法糖尿病性ERM患者分为ERM+ILM剥离组(18眼)和ERM剥离组(19眼),均行标准玻璃体切除术,随访至术后6个月。比较两组患者的最佳矫正视力(BCVA)、中央黄斑厚度(CMT)、血管密度(VD)、血管长度密度(VLD)、中心凹无血管区(FAZ)面积和中心凹无血管区(FAZ)圆度。结果ILM剥离对两组患者的BCVA、CMT的变化没有影响,差异无统计学意义(P>0.05)。在浅表毛细血管丛(SCP)中,ILM剥离与否不影响VD、VLD、FAZ面积和FAZ圆度的变化,差异无统计学意义(P>0.05)。在深部毛细血管丛(DCP)中,ILM剥离对VD、VLD和FAZ圆度的变化有影响,差异有统计学意义(P<0.05);ERM+ILM剥离组术后第6个月的VD、VLD和FAZ圆度与ERM剥离组差异有统计学意义(P<0.05)。结论糖尿病性ERM患者术中剥离ILM延迟了黄斑区深部毛细血管丛血流信号的改善,增加了深部黄斑缺血的风险,但不影响术后BCVA和CMT的恢复。Objective To study the effect of intraoperative internal limiting membrane(ILM)peeling on the macular vascular structure in patients with diabetic epiretinal membrane(ERM).Methods Patients with diabetic ERM were divided into ERM+ILM peeling group(18 eyes)and ILM peeling group(19 eyes),all of whom underwent standard vitrectomy and were followed up until 6 months postoperatively.Best-corrected visual acuity(BCVA),Central macular thickness(CMT),Vessel density(VD),Vessel length density(VLD),Foveal avascular zone(FAZ)area,and Foveal avascular zone(FAZ)circularity were compared between the two groups.Results ILM peeling had no effect on the changes of BCVA(P>0.05)and CMT(P>0.05)in the two groups.In the superficial capillary plexus(SCP),the change in VD(P>0.05),VLD(P>0.05),FAZ area(P>0.05)and FAZ circularity(P>0.05)were not affected by ILM peeling.For the deep capillary plexus(DCP),there was an impact of ILM peeling on the changes in VD(P<0.05),VLD(P<0.05)and FAZ circularity(P<0.05);the VD(P<0.05),VLD(P<0.05)and FAZ circularity(P<0.05)in the ERM+ILM peeling group at 6 month postoperatively were significantly different from those in the ERM peeling group.Conclusion Intraoperative peeling of the ILM in patients with diabetic ERM delays the improvement of blood flow signal in the DCP and increases the risk of deep macular ischemia,but does not affect the recovery of postoperative BCVA and CMT.

关 键 词：糖尿病 视网膜前膜 内界膜 血管密度 血管长度密度 黄斑缺血 

分 类 号：R779.6[医药卫生—眼科]