难治性青光眼患者内路直视睫状体光凝手术前后脉络膜厚度、血流密度变化及其与视力改善相关性  

Changes in Choroidal Thickness and Blood Flow Density before and after Endoscopic Cyclophotocoagulation Via Direct Internal Approach in Patients with Refractory Glaucoma and Their Correlation with Visual Improvement

作　　者：陈洁 陈琦[2] CHEN Jie;CHEN Qi(Department of Ophthalmology,Red Cross Hospital of Nanning City,Nanning 530000,China;Optometry Center,People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530000,China)

机构地区：[1]南宁市红十字会医院眼科,南宁530000 [2]广西壮族自治区人民医院视光中心,南宁530000

出　　处：《临床误诊误治》2024年第2期87-93,共7页Clinical Misdiagnosis & Mistherapy

基　　金：广西壮族自治区卫生健康委自筹经费科研课题(Z-A20231262)。

摘　　要：目的探究难治性青光眼患者内路直视睫状体光凝手术前后脉络膜厚度、血流密度变化及其与视力改善相关性。方法选取2021年1月—2023年1月拟行内路直视睫状体光凝手术的130例难治性青光眼(130只患眼),将130只患眼作为研究组,130只对侧正常眼作为对照组。比较2组术前眼球中心凹颞侧2500μm处(T2.5)和从眼球中心凹处往鼻侧(N0.5~N2.5)及研究组术前、术后6个月T2.5黄斑区脉络膜厚度和血流密度,不同视力改善情况难治性青光眼患者患眼术前、术后6个月T2.5黄斑区脉络膜厚度、血流密度及其手术前后变化值绝对值。分析研究组术前T2.5、N0.5~N2.5黄斑区脉络膜厚度与血流密度的相关性,T2.5黄斑区脉络膜厚度和血流密度手术前后变化值绝对值与难治性青光眼患者患眼视力改善情况相关性,探讨T2.5黄斑区脉络膜厚度和血流密度手术前后变化值绝对值评估难治性青光眼患者患眼内路直视睫状体光凝手术后视力改善价值。结果研究组术前T2.5和N0.5~N2.5黄斑区脉络膜厚度和血流密度薄于或低于对照组,研究组术前T2.5和N0.5~N2.5黄斑区脉络膜厚度与血流密度呈正相关(P<0.01)。研究组术后6个月T2.5黄斑区脉络膜厚度和血流密度均大于术前(P<0.01)。视力改善难治性青光眼患者患眼术后6个月T2.5黄斑区脉络膜厚度、血流密度及其手术前后变化值绝对值大于视力不变和视力降低患者,视力不变患者大于视力降低患者(P<0.05)。T2.5黄斑区脉络膜厚度、血流密度手术前后变化值绝对值与难治性青光眼患者患眼视力改善情况呈正相关(P<0.05)。受试者工作特征曲线结果显示,T2.5黄斑区脉络膜厚度和血流密度手术前后变化值绝对值联合评估难治性青光眼患者患眼内路直视睫状体光凝手术后视力改善价值的曲线下面积为0.911,高于单独评估的0.760和0.829(P<0.05)。结论难治性青光眼患者患眼T2.5和N0.5~Objective To investigate the changes of choroidal thickness and blood flow density in patients with refractory glaucoma(RG)before and after endoscopic cyclophotocoagulation(ECP)via direct internal approach,and their correlation with visual improvement.Methods A total of 130 patients(130 eyes)with RG who were scheduled to undergo ECP via direct internal approach in our hospital from January 2021 to January 2023 were selected,the 130 affected eyes were used as the research group,and the 130 contralateral eyes were used as the control group.The choroidal blood flow density at 2500μm temporally from the fovea centralis(T2.5),and from the fovea centralis to the nasal side(N0.5-N2.5)as well as at T2.5 in the macular area were compared between the two groups before treatment as well as before treatment and at 6 months after treatment.The choroidal thickness and blood flow density in the macular area as well as the absolute values of their preoperative and postoperative changes in RG patients with different levels of visual improvement before and at 6 months after surgery were compared between the two groups.The correlation between choroidal thickness and blood flow density at T2.5 and N0.5-N2.5 in the macular area before surgery in the research group was analyzed,and the correlation of the absolute values of changes in choroidal thickness and blood flow density in the macular area before and after surgery with visual improvement in affected eyes of patients with RG was analyzed.The value of the absolute values of changes in choroidal thickness and blood flow density at T2.5 in the macular area before and after surgery for visual improvement in RG patients undergoing ECP via direct internal approach was explored.Results Choroidal thickness and blood flow density at T2.5 and N0.5-N2.5 in the macular area of the research group were smaller or lower than those in the control group(P<0.01),and choroid thickness at T2.5 and N0.5-N2.5 in macular area was positively correlated with blood flow density in the research group befo

关 键 词：青光眼 难治性 内路直视睫状体光凝术 脉络膜厚度 脉络膜血流密度 Pearson相关性分析 Spearman相关性分析 受试者工作特征曲线 

分 类 号：R775[医药卫生—眼科]