CAJ | 학술논문

目的评价黄斑裂孔指数(MHI)与特发性黄斑裂孔(IMH)视网膜内界膜剥离手术后视力预后的相关性.方法 30例接受玻璃体切割联合视网膜内界膜剥离手术治疗的IMH患者的30只眼纳入研究.患者均进行最佳矫正视力(BCVA)、裂隙灯显微镜、间接检眼镜及光相干断层扫描(OCT)检查确诊.OCT测量视网膜中心厚度,黄斑裂孔底径和高,计算黄斑裂孔高与底径比值,即MHI,并根据MHI大小将患者分为MHI≥0.5组和MHI＜0.5组.手术后随访3～24个月,平均随访时间10个月.将手术后BCVA与患者年龄、病程、MHI及手术前BCVA进行斯珀曼(Spearman)相关性分析,对MHI≥0.5组和MHI＜0.5组手术后BCVA差异进行独立样本设计定量资料t检验.结果手术后30只眼黄斑裂孔闭合,闭合率为100%.患者手术后BCVA与MHI之间有相关性(r=0.852,P＜0.001),与年龄、病程等变量无相关性(r年龄=0.001,P=0.804;r病程=-0.001,P=0.579).MHI≥0.5组手术后视力好于MHI＜0.5组(t=5.552,P＜0.001).结论 MHI与IMH患者视网膜内界膜剥离手术后视力存在相关性,可作为其手术后视力的预测指标之一.
목적 평개황반렬공지수(MHI)여특발성황반렬공(IMH)시망막내계막박리수술후시력예후적상관성.방법 30례접수파리체절할연합시망막내계막박리수술치료적IMH환자적30지안납입연구.환자균진행최가교정시력(BCVA)、렬극등현미경、간접검안경급광상간단층소묘(OCT)검사학진.OCT측량시망막중심후도,황반렬공저경화고,계산황반렬공고여저경비치,즉MHI,병근거MHI대소장환자분위MHI≥0.5조화MHI＜0.5조.수술후수방3～24개월,평균수방시간10개월.장수술후BCVA여환자년령、병정、MHI급수술전BCVA진행사박만(Spearman)상관성분석,대MHI≥0.5조화MHI＜0.5조수술후BCVA차이진행독립양본설계정량자료t검험.결과 수술후30지안황반렬공폐합,폐합솔위100%.환자수술후BCVA여MHI지간유상관성(r=0.852,P＜0.001),여년령、병정등변량무상관성(r년령=0.001,P=0.804;r병정=-0.001,P=0.579).MHI≥0.5조수술후시력호우MHI＜0.5조(t=5.552,P＜0.001).결론 MHI여IMH환자시망막내계막박리수술후시력존재상관성,가작위기수술후시력적예측지표지일.
Objective To evaluate the relevance of the macular hole index (MHI) and the visual outcomes of the idiopathic macular hole (IMH) after the retinal internal limiting membrane (ILM) peeling surgery. Methods Thirty IMH patients (30 eyes) undergoing vitrectomy and ILM peeling were included in this study. The IMH diagnosis was confirmed by best corrected visual acuity (BCVA), slit lamp microscope, indirect ophthalmoscope and optical coherence tomography (OCT). The central retinal thickness, the height and the base diameter of macular holes were measured by OCT. The MHI was the ratio of the height and the base diameter of macular holes. The patients were divided into two groups (MHI ≥0.5 group and MHI ＜0. 5 group) according to the MHI. The post-surgery follow-up was three to 24 months with an average of 10 months. Spearman correlation analysis was performed between BCVA (pre and post-surgery), age, disease duration and MHI. The differences in BCVA after surgery between the two MHI groups was further evaluated by independent samples t test for quantitative data. Results All the macular holes in 30 eyes closed after surgery, closure rate was 100%. Postoperative BCVA was correlated with MHI by Spearman analysis (r=0.852, P＜0.001), but not correlated with age (r=0.001, P=0.804) and disease course (r=-0. 001, P=0. 579). Postoperative BCVA was better in the MHI≥0. 5 group (t = 5. 552, P ＜ 0. 001 ). Conclusions The postoperative visual outcome of IMH patients was correlated with the MHI. MHI can be used as a prognostic factor of postoperative visual outcomes for IMH patients.