CAJ | 학술논문

目的观察高度近视视网膜劈裂患者行玻璃体切割手术前后谱域光相干断层扫描(SD-OCT)的影像学特征.方法回顾性分析SD-OCT检查确诊为高度近视视网膜劈裂不伴黄斑裂孔行玻璃体切割手术治疗的8例患者8只眼临床资料.所有患者均行矫正视力、屈光度、前置镜眼底检查、A/B型超声及SD-OCT检查.所有患眼视网膜均存在外层劈裂.其中,合并中层或内层劈裂5只眼,伴中心凹脱离5只眼.前置镜检查结果显示,8只眼中,黄斑中心凹出现局限性浅脱离3只眼;未发现明显异常5只眼.后极部出现巩膜葡萄肿7只眼.SD-OCT检查结果显示,后极部视网膜呈现明显向下凹陷的弧形条带7只眼;未见明显向下凹陷的弧形条带1只眼.所有患眼均接受玻璃体切割加内界膜剥除手术治疗.手术后1、3、6个行时SD-OCT复查,对比观察手术前后视网膜后极部形态结构影像检查特征变化.结果手术后6个月,后极部劈裂消失视网膜基本贴附原位6只眼;仍存在中心凹脱离1只眼;出现旁中心凹裂孔1只眼.手术后6个月,矫正视力由手术前0.15提高至0.8者1只眼,SD-OCT检查显示,视网膜光感受器内外节(IS/OS)连接光带层连续性大部分恢复.矫正视力由手术前0.01和0.05提高至0.1和0.15者2只眼;保持不变者5只眼.SD-OCT检查结果显示,手术后IS/OS连接光带层均仍有缺失.结论高度近视视网膜劈裂在SD-OCT中形态表现多样,以外层劈裂居多.
목적 관찰고도근시시망막벽렬환자행파리체절할수술전후보역광상간단층소묘(SD-OCT)적영상학특정.방법 회고성분석SD-OCT검사학진위고도근시시망막벽렬불반황반렬공행파리체절할수술치료적8례환자8지안림상자료.소유환자균행교정시력、굴광도、전치경안저검사、A/B형초성급SD-OCT검사.소유환안시망막균존재외층벽렬.기중,합병중층혹내층벽렬5지안,반중심요탈리5지안.전치경검사결과현시,8지안중,황반중심요출현국한성천탈리3지안;미발현명현이상5지안.후겁부출현공막포도종7지안.SD-OCT검사결과현시,후겁부시망막정현명현향하요함적호형조대7지안;미견명현향하요함적호형조대1지안.소유환안균접수파리체절할가내계막박제수술치료.수술후1、3、6개행시SD-OCT복사,대비관찰수술전후시망막후겁부형태결구영상검사특정변화.결과 수술후6개월,후겁부벽렬소실시망막기본첩부원위6지안;잉존재중심요탈리1지안;출현방중심요렬공1지안.수술후6개월,교정시력유수술전0.15제고지0.8자1지안,SD-OCT검사현시,시망막광감수기내외절(IS/OS)련접광대층련속성대부분회복.교정시력유수술전0.01화0.05제고지0.1화0.15자2지안;보지불변자5지안.SD-OCT검사결과현시,수술후IS/OS련접광대층균잉유결실.결론 고도근시시망막벽렬재SD-OCT중형태표현다양,이외층벽렬거다.
Objective To observe the image features of high myopia with retinoschisis by spectraldomain optical coherence tomography (SD-OCT). Methods The clinical data of eight patients (eight eyes)of high myopia with retinoschisis were retrospective analyzed. All patients were diagnosed by SD-OCT (Topcon 3D OCT-1000), had no macular holes and underwent vitrectomy including internal limiting membrane (ILM) peeling and gas tamponade. All patients also underwent visual acuity, refraction,pre-mirror fundus examination and A/B-mode ultrasound examination. Visual acuity and SD-OCT were followed up at one, three and six months after surgery. Before surgery, pre-mirror fundus examination revealed shallow foveal detachment in 3/8 eyes, posterior scleral staphyloma in 7/8 eyes. SD-OCT showed concave arc stripes in 7/8 eyes, and outer retinoschisis in 8/8 eyes, middle or inner retinoschisis in 5/8 eyes and foveal detachment in 5/8 eyes. Results Six months after surgery, posterior retinoschisis disappeared in six eyes, foveal detachment still presented in one eye and parafoveal hole occurred in one eye. The corrected visual acuity improved from the 0. 15 to 0. 8 in one eye which had a restored continuous inner segment/outer segmen (IS/OS) line by SD-OCT. The corxected visual acuity improved from 0. 01 to 0. 1 in one eye, from 0. 05 to 0. 15 in one eye, not changed in five eyes. There was no continuous IS/OS line in those patients by SD-OCT. Conclusions SD-OCT shows a variety of morphological features of myopic retinoschisis which could be cured anatomically and functionally by vitrectomy combined ILM peeling. The continuity of IS/OS layer from SD-OCT could help to interpret the vision recovery after the operation.