玻璃体切除联合超声乳化白内障吸除术后特发性视网膜前膜患者脉络膜血管指数的变化  

Changes in choroidal vascularity index after vitrectomy combined with phacoemulsification in idiopathic epiretinal membrane

作　　者：姚慧萍[1] 刘晓庆 周瑜峰 王佳军 杨子建[1] Yao Huiping;Liu Xiaoqing;Zhou Yufeng;Wang Jiajun;Yang Zijian(Department of Ophthalmology,Ruijin Hospital Affliated to Shanghai Jiaotong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属瑞金医院眼科,上海200011

出　　处：《中华眼外伤职业眼病杂志》2024年第4期256-263,共8页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察特发性视网膜前膜(IERM)患者经睫状体平坦部玻璃体切除(PPV)联合超声乳化白内障吸除术后脉络膜血管指数(CVI)的变化。方法回顾性病例系列研究。纳入上海交通大学医学院附属瑞金医院2021年1月至2023年6月进行PPV联合超声乳化白内障吸除术的IERM患者24例(24只眼)。所有患者均采用扫频源光学相干断层扫描(SS-OCT),在术前及术后1周、1个月、3个月对脉络膜和视网膜结构进行随访观察。分析术后CVI、脉络膜厚度、视网膜厚度、眼压和最佳矫正视力(BCVA,logMAR)的变化。结果患者术后3个月BCVA为0.31±0.16,相比术前BCVA(0.62±0.33),差异有统计学意义(t=4.36,P<0.001)。术前和术后各时间点眼压比较,总体差异有统计学意义(F=3.90,P=0.022);术后1周、1个月眼压与术前相比显著降低,差异均有统计学意义(P=0.013、0.039)。术前CVI为(60.21±1.86)%,术后1周、1个月及3个月的CVI依次为(61.88±1.77)%,(62.23±1.62)%及(62.37±2.18)%,总体比较差异有统计学意义(F=10.56,P=0.001);术后1周、1个月及3个月的CVI,均较术前增加,差异有统计学意义(均P<0.05)。在中心凹区、旁中心凹和中心凹周围区,术前和术后平均脉络膜厚度比较,差异均有统计学意义(F=12.04、18.61、10.71,P<0.001、P<0.001、P=0.001)。中心凹的平均脉络膜厚度术后1周、1个月及3个月依次为(180.5±68.6)、(198.5±62.3)、(185.0±56.5)μm,旁中心凹脉络膜厚度依次为(175.9±64.2)、(191.0±56.6)、(177.2±49.1)μm;中心凹周围区依次为(164.0±63.8)、(172.2±51.3)、(157.1±41.7)μm,均较术前增厚,与术前比较,差异有统计学意义(均P<0.05)。在中心凹区、旁中心凹区、中心凹周围区,术前术后视网膜厚度比较差异均有统计学意义(H=27.90、57.75、36.01;均P<0.001);在中心凹区,术后1周、1个月和3个月与术前相比,差异有统计学意义(P=0.004、P=0.001、P<0.001);在旁中心凹区,术后1周、1个月和3个月与术前相ObjectiveTo observe the changes of choroidal vascular index(CVI)in patients with idiopathic epiretinal membrane(IERM)after pars plana vitrectomy(PPV)combined with phacoemulsification.MethodsThis was a retrospective cases series study.A total of 24 eyes of 24 IERM patients who underwent PPV combined with phacoemulsification in Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from Jan.2021 to Jun.2023 were included.The retinal and choroidal structures of the affected eyes were observed by swept-source optical coherence tomograph(SS-OCT)before surgery and at 1 week,1 and 3 months after surgery.Preoperative and postoperative choroidal vascularity index,choroidal thickness and retinal thickness,intraocular pressure(IOP),and best-corrected visual acuity(BCVA)were analyzed.ResultsBCVA(logMAR)before surgery was 0.62±0.33,and 0.31±0.16 at 3 months after surgery,which significantly improved after surgery(t=4.36,P<0.001).There was significant difference in IOP between preoperative and postoperative follow-up(F=3.90,P=0.022).IOP at 1 week and 1 month after surgery was significantly lower than that before surgery(P=0.013,0.039).The preoperative CVI was(60.21±1.86)%,and the postoperative CVI was(61.88±1.77)%,(62.23±1.62)%and(62.37±2.18)%at 1 week,1 month and 3 months,respectively,and the difference was statistically significant before and after sturgery(F=10.56,P=0.001).CVI at 1 week,1 month and 3 months after surgery increased compared with that before surgery,and the differences were statistically significant(all P<0.05).There were significant differences in mean choroidal thickness at 1 week,1 month and 3 months after surgery in fovea,parafovea and perifovea(F=12.04,18.61,10.71;P<0.001,P<0.001,P=0.001).Mean choroidal thickness in fovea was(180.5±68.6)μm at 1 week,(198.5±62.3)μm at 1 month and(185.0±56.5)μm at 3 months after surgery,respectively;parafoveal mean choroidal thickness was(175.9±64.2),(191.0±56.6)and(177.2±49.1)μm,respectively,and perifoveal mean choroidal thickness wa

关 键 词：体层摄影术 光学相干 玻璃体切除术 脉络膜血管指数 厚度 视网膜 脉络膜 超声乳化白内障吸除术 

分 类 号：R779.6[医药卫生—眼科]