特发性黄斑裂孔视网膜内囊腔截面积与视网膜血流密度的关系及对视网膜功能的影响  

Relationship between macular hole cavity cross-sectional area and retinal blood flow density and its impact on retinal function in idiopathic macular holes

作　　者：桂辰巍 李静 高燕 王文娟 张潇丹 王晶晶 周国宏 Gui Chenwei;Li Jing;Gao Yan;Wang Wenjuan;Zhang Xiaodan;Wang Jingjing;Zhou Guohong

机构地区：[1]山西省眼科医院、山西医科大学附属眼科医院,太原030002

出　　处：《中华眼科杂志》2023年第11期888-898,共11页Chinese Journal of Ophthalmology

基　　金：山西省科技厅重点研发计划(201903D321117);山西省卫生厅“四个一批”重点项目(2020RC22)。

摘　　要：目的探讨特发性黄斑裂孔(IMH)视网膜内囊腔截面积与视网膜各层血流密度的相关性,以及囊腔截面积对术前和术后视网膜功能的影响。方法回顾性队列研究。收集2019年8月至2021年12月于山西医科大学附属眼科医院诊断为IMH并行玻璃体切除联合内界膜剥除术的18例(18只眼)患者的临床资料。所有患者术前及术后1、3、6个月均行视力及最佳矫正视力(BCVA)、谱域相干光层析成像术(SD-OCT)、相干光层析血管成像术(OCTA)及多焦视网膜电图(mfERG)检查。收集视网膜各层的整体、黄斑中心凹及黄斑旁中心凹的血流密度数据,并使用ImageJ软件测量囊腔截面积。收集同时期于山西医科大学附属眼科医院行mfERG的10名无眼底病变的受试者作为对照组,将其mfERG检查结果与IMH患者(IMH组)对比,每名受试者选取一只眼纳入研究,随机选取5只左眼和5只右眼。采用Pearson相关分析、独立样本t检验和重复测量方差分析进行统计学处理。结果18例(18只眼)IMH患者均为单眼患病;男性3例,女性15例;年龄为(64.22±4.33)岁,病程为75(38,120)d。对照组10名受试者中,男性4名,女性6名;年龄(63.67±6.96)岁。术前18只患眼均可见视网膜内囊腔,术后1个月时黄斑裂孔均闭合且囊腔消失。囊腔总截面积为(4.84±2.28)mm2,平均截面积为(0.27±0.13)mm2。囊腔截面积与裂孔高度(r=0.82,P<0.001)、椭圆体带缺失直径(r=0.74,P<0.001)和术前BCVA(r=0.62,P=0.006)相关。囊腔截面积与视网膜浅层黄斑中心凹的血流密度呈正相关(r=0.47,P=0.049),与视网膜深层血流密度(r=-0.50,P=0.033)及深层黄斑旁中心凹血流密度(r=-0.65,P=0.003)呈负相关。与对照组健眼相比,IMH患眼mfERG的P1波和N1波振幅均降低,P1波潜伏期除1环(黄斑中心凹向外2.18°)外均延长,N1波潜伏期除2环(黄斑中心凹向外7.46°)与5环(黄斑中心凹向外29.75°)外均延长(均P<0.05)。囊腔截面积仅与术前2环N1波的潜�Objective To investigate the correlation between the cross-sectional area of the macular hole(MH)cavity and the blood flow density in different retinal layers,as well as the impact of cavity size on preoperative and postoperative retinal function in patients with idiopathic macular holes(IMH).Methods A retrospective cohort study was conducted.Clinical data were collected from 18 patients(18 eyes)diagnosed with IMH who underwent vitrectomy combined with internal limiting membrane peeling at Shanxi Eye Hospital affiliated to Shanxi Medical University from August 2019 to December 2021.Visual acuity,best-corrected visual acuity(BCVA),spectral-domain optical coherence tomography(SD-OCT),optical coherence tomography angiography(OCTA),and multifocal electroretinography(mfERG)were performed preoperatively and at 1,3,and 6 months postoperatively.Blood flow density data were collected for the overall retina,macular center fovea,and parafoveal regions,and the cavity cross-sectional area was measured using ImageJ software.Ten healthy subjects without retinal abnormalities who underwent mfERG at Shanxi Eye Hospital affiliated to Shanxi Medical University during the same period were included as a control group.One eye was randomly selected for each subject,with 5 left eyes and 5 right eyes.Statistical analysis was performed using Pearson correlation analysis,independent samples t-test,and repeated measures analysis of variance.Results All 18 IMH patients had unilateral disease,including 3 males and 15 females,with an average age of(64.22±4.33)years and a duration of illness of 75(38,120)days.In the control group,consisting of 10 subjects,4 were male and 6 were female,with an average age of(63.67±6.96)years.Preoperatively,all 18 affected eyes exhibited a macular hole cavity,which closed and disappeared one month postoperatively.The total cavity cross-sectional area was(4.84±2.28)mm2,with an average area of(0.27±0.13)mm2.The cavity cross-sectional area was positively correlated with the MH height(r=0.82,P<0.001),ellipsoid zo

关 键 词：视网膜穿孔 视网膜 中央凹 局部血流 血流速度 体层摄影术 光学相干 血管造影术 视网膜电描记术 视敏度 

分 类 号：R774[医药卫生—眼科]