外伤性黄斑裂孔与特发性黄斑裂孔的光相干断层扫描图像特征比较  

Comparison of optical coherence tomography image features between traumatic macular hole and idiopathic macular hole

作　　者：史庭坤 夏红和[1] 金创 柯喜宣 张琦[1] 廖栩龙 程缨淋 黄育强[1] 陈浩宇[1] Shi Tingkun;Xia Honghe;Jin Chuang;Ke Xixuan;Zhang Qi;Liao Xulong;Cheng Yinglin;Huang Yuqiang;Chen Haoyu(Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong,Shantou 515041,China)

机构地区：[1]汕头大学·香港中文大学联合汕头国际眼科中心,汕头515041

出　　处：《中华眼底病杂志》2025年第4期289-293,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：广东省医学科研基金(B2024255)。

摘　　要：目的对比观察外伤性黄斑裂孔(TMH)与特发性黄斑裂孔(IMH)的光相干断层扫描(OCT)图像特征。方法回顾性临床研究。2008年12月至2024年5月在汕头国际眼科中心检查确诊的黄斑裂孔患者174例174只眼纳入研究。其中,TMH、IMH分别为75例75只眼、99例99只眼,并据此分为TMH组、IMH组。患眼均行最佳矫正视力(BCVA)、OCT检查。BCVA检查采用标准对数视力表进行,统计时换算为最小分辨角对数(logMAR)视力。采用OCT测量裂孔最小直径、基底部直径以及裂孔边缘平均、鼻侧、上方、下方、颞侧的中央视网膜厚度(CRT)。组间logMAR BCVA、裂孔直径、裂孔边缘CRT比较采用独立样本t检验。结果TMH组、IMH组患者年龄(t=−15.857)、性别构成比(χ^(2)=22.487)比较,差异有统计学意义(P<0.05);logMAR BCVA比较,差异无统计学意义(t=1.962,P>0.05)。TMH组患眼裂孔最小直径较IMH组小,但基底部直径更大,差异均有统计学意义(t=−3.322、2.570,P<0.05);TMH组裂孔边缘CRT较IMH组薄,上方(t=−2.747)、下方(t=−2.316)、鼻侧(t=−2.851)差异均有统计学意义(P<0.05),颞侧差异无统计学意义(t=−1.586,P>0.05)。TMH组患眼合并黄斑囊样水肿(CME)、玻璃体后脱离(PVD)、视网膜萎缩、视网膜下出血、脉络膜裂伤、神经上皮层局限性脱离分别为36(48.00%,36/75)、4(5.33%,4/75)、4(5.33%,4/75)、15(20.00%,15/75)、8(10.67%,8/75)、19(25.33%,19/75)只眼;IMH组合并CME、PVD分别为95(95.96%,95/99)、94(94.95%,94/99)只眼。结论与IMH比较,TMH裂孔基底部直径更大,裂孔边缘CRT更薄;更少合并CME和PVD,更多合并视网膜下出血、神经上皮层局限性脱离、脉络膜裂伤、视网膜萎缩。Objective To comparatively observe optical coherence tomography(OCT)image features between traumatic macular hole(TMH)and idiopathic macular hole(IMH).Methods A retrospective clinical study.A total of 174 patients(174 eyes)with macular hole(MH)diagnosed at Shantou International Eye Center from December 2008 to May 2024 were included in the study.Among them,there were 75 patients(75 eyes)with TMH and 99 patients(99 eyes)with IMH,and they were divided into the TMH group and the IMH group accordingly.All the affected eyes underwent best corrected visual acuity(BCVA)and OCT examinations.The BCVA was examined using a standard logarithmic visual acuity chart,and was converted to the logarithm of the minimum angle of resolution(logMAR)visual acuity for statistical analysis.The minimum diameter and basal diameter of the MH,as well as the average,nasal,superior,inferior,and temporal center retinal thickness(CRT)around the MH were measured by OCT.The independent-sample t test was used to compare the logMAR BCVA,hole diameter,and CRT at the hole margin between the groups.Results There were significant differences in age(t=−15.857)and gender ratio(χ^(2)=28.154)between the TMH group and the IMH group(P<0.05),while there was no significant difference in logMAR BCVA(t=1.962,P>0.05).The minimum diameter of the hole in the TMH group was smaller than that in the IMH group,but the basal diameter was larger,with significant differences(t=−3.322,2.570;P<0.05).The thickness of the neuroepithelial layer at the hole margin in the TMH group was thinner than that in the IMH group,with significant differences in the superior(t=−2.747),inferior(t=−2.316),and nasal(t=−2.851)regions(P<0.05),and no significant difference in the temporal region(t=−1.586,P>0.05).In the TMH group,the number of eyes with macular cystoid edema(CME),posterior vitreous detachment(PVD),retinal atrophy,subretinal hemorrhage,choroidal laceration,and focal neuroepithelial detachment was 36(48.00%,36/75),4(5.33%,4/75),4(5.33%,4/75),15(20.00%,15/75),8(10.67%,8

关 键 词：外伤性黄斑裂孔 特发性黄斑裂孔 光相干断层扫描 中央视网膜厚度 

分 类 号：R774.1[医药卫生—眼科]