目的：对特发性黄斑裂孔患者进行玻璃体切割手术( pars plana vitrectomy, PPV)及内界膜( inner limiting membrane, ILM)剥除、气体眼内填充后,应用频域光学相干断层扫描仪( spectral domain optical coherence tomography,SD-OCT)观察黄斑裂孔术后的闭合黄斑孔的黄斑区视网膜厚度( retinal thickness,RT)变化。<br> 方法：非随机、回顾性临床病例研究。筛选我院2011-03-01/2013-06-30入院诊断为“特发性黄斑裂孔”的患者17例17眼,均为同一术者行25 G-PPV和ILM剥除、短效气体填充、黄斑孔闭合良好、随访观察超过6 mo以上者。所有患者术后均使用Topcon公司SD-OCT进行术眼及对侧正常眼的黄斑区线性扫描检测黄斑区视网膜厚度变化。黄斑区视网膜厚度根据ETDRS分成9个区域。术后观察随访时间分别为术后3~5wk(A 期)、术后2~3mo(B期)、术后>6mo(C期)。<br> 结果：在A期中,OCT检查的黄斑区视网膜厚度：术眼C, IS,II,IN,OS,OI和ON较对侧眼相应区域的厚度增加( P<0.01),而IT和OT(291.58±18.97μm,250.83±21.21μm)较对侧眼(280.33±20.82μm,242.08±24.02μm)的差异无统计学意义(P>0.01)。在B期中,术眼II,IN,OS和ON区域较对侧眼相应区域视网膜厚度增加(P<0.01),而术眼C,IS,IT,OI和OT区域较对侧正常眼相应区域的视网膜厚度值差异无统计学意义(P>0.01)。 C期中,除术眼IN区较对侧眼厚度增加外(P<0.01),余C,IS,II,IT,OS, OI,ON和OT较对侧眼相应区域厚度均无明显变化( P>0.01)。另外,C期的术眼ON和IT视网膜厚度较A期有明显下降(P<0.01)。<br> 结论：特发性黄斑裂孔术后出现黄斑区视网膜厚度的持续变化,可能与ILM的剥除导致黄斑区显微组织结构的变化有关。 SD-OCT为黄斑裂孔术后随访观察提供了客观便捷的观察工具,为进一步研究ILM 剥除对黄斑区视网膜的远期结构及对视功能的影响提供了依据。
目的：對特髮性黃斑裂孔患者進行玻璃體切割手術( pars plana vitrectomy, PPV)及內界膜( inner limiting membrane, ILM)剝除、氣體眼內填充後,應用頻域光學相榦斷層掃描儀( spectral domain optical coherence tomography,SD-OCT)觀察黃斑裂孔術後的閉閤黃斑孔的黃斑區視網膜厚度( retinal thickness,RT)變化。<br> 方法：非隨機、迴顧性臨床病例研究。篩選我院2011-03-01/2013-06-30入院診斷為“特髮性黃斑裂孔”的患者17例17眼,均為同一術者行25 G-PPV和ILM剝除、短效氣體填充、黃斑孔閉閤良好、隨訪觀察超過6 mo以上者。所有患者術後均使用Topcon公司SD-OCT進行術眼及對側正常眼的黃斑區線性掃描檢測黃斑區視網膜厚度變化。黃斑區視網膜厚度根據ETDRS分成9箇區域。術後觀察隨訪時間分彆為術後3~5wk(A 期)、術後2~3mo(B期)、術後>6mo(C期)。<br> 結果：在A期中,OCT檢查的黃斑區視網膜厚度：術眼C, IS,II,IN,OS,OI和ON較對側眼相應區域的厚度增加( P<0.01),而IT和OT(291.58±18.97μm,250.83±21.21μm)較對側眼(280.33±20.82μm,242.08±24.02μm)的差異無統計學意義(P>0.01)。在B期中,術眼II,IN,OS和ON區域較對側眼相應區域視網膜厚度增加(P<0.01),而術眼C,IS,IT,OI和OT區域較對側正常眼相應區域的視網膜厚度值差異無統計學意義(P>0.01)。 C期中,除術眼IN區較對側眼厚度增加外(P<0.01),餘C,IS,II,IT,OS, OI,ON和OT較對側眼相應區域厚度均無明顯變化( P>0.01)。另外,C期的術眼ON和IT視網膜厚度較A期有明顯下降(P<0.01)。<br> 結論：特髮性黃斑裂孔術後齣現黃斑區視網膜厚度的持續變化,可能與ILM的剝除導緻黃斑區顯微組織結構的變化有關。 SD-OCT為黃斑裂孔術後隨訪觀察提供瞭客觀便捷的觀察工具,為進一步研究ILM 剝除對黃斑區視網膜的遠期結構及對視功能的影響提供瞭依據。
목적：대특발성황반렬공환자진행파리체절할수술( pars plana vitrectomy, PPV)급내계막( inner limiting membrane, ILM)박제、기체안내전충후,응용빈역광학상간단층소묘의( spectral domain optical coherence tomography,SD-OCT)관찰황반렬공술후적폐합황반공적황반구시망막후도( retinal thickness,RT)변화。<br> 방법：비수궤、회고성림상병례연구。사선아원2011-03-01/2013-06-30입원진단위“특발성황반렬공”적환자17례17안,균위동일술자행25 G-PPV화ILM박제、단효기체전충、황반공폐합량호、수방관찰초과6 mo이상자。소유환자술후균사용Topcon공사SD-OCT진행술안급대측정상안적황반구선성소묘검측황반구시망막후도변화。황반구시망막후도근거ETDRS분성9개구역。술후관찰수방시간분별위술후3~5wk(A 기)、술후2~3mo(B기)、술후>6mo(C기)。<br> 결과：재A기중,OCT검사적황반구시망막후도：술안C, IS,II,IN,OS,OI화ON교대측안상응구역적후도증가( P<0.01),이IT화OT(291.58±18.97μm,250.83±21.21μm)교대측안(280.33±20.82μm,242.08±24.02μm)적차이무통계학의의(P>0.01)。재B기중,술안II,IN,OS화ON구역교대측안상응구역시망막후도증가(P<0.01),이술안C,IS,IT,OI화OT구역교대측정상안상응구역적시망막후도치차이무통계학의의(P>0.01)。 C기중,제술안IN구교대측안후도증가외(P<0.01),여C,IS,II,IT,OS, OI,ON화OT교대측안상응구역후도균무명현변화( P>0.01)。령외,C기적술안ON화IT시망막후도교A기유명현하강(P<0.01)。<br> 결론：특발성황반렬공술후출현황반구시망막후도적지속변화,가능여ILM적박제도치황반구현미조직결구적변화유관。 SD-OCT위황반렬공술후수방관찰제공료객관편첩적관찰공구,위진일보연구ILM 박제대황반구시망막적원기결구급대시공능적영향제공료의거。
AlM:To determine the changes of regional macular retinal thickness ( RT ) with spectral domain optical coherence tomography ( SD-OCT ) after successful pars plana vitrectomy ( PPV ) surgery with inner limiting membrane ( lLM ) peeling in patients with idiopathic macular hole. <br> METHODS:A non-randomized retrospective case study on 17 patients ( 17 eyes ) who were hospitalized between March 1, 2011 and June 30, 2013. All 17 eyes had been diagnosed with idiopathic macular hole and thereafter underwent 25G-PPV surgeries performed by the same surgeon with lLM peeling and short - term gas tamponade. ln the 6mo-plus follow-up after surgery, these eyes were found to have successful closure in the macular hole. The macular RT of the nine areas in the Early Treatment Diabetic Retinopathy Study was measured by SD-OCT. All patients were applied by SD-OCT with linear scan of the macular. At least four examinations on the operated eye were conducted in contrast to the other normal eye: before the surgery, 3~5wk after the surgery (stage A), 2~3mo after the surgery (stage B), and >6mo after the surgery (stage C). <br> RESULTS:ln stage A, the macular RT of operated eyes in the areas of C, lS, ll, lN, OS, Ol, ON (263. 00±39. 48, 313. 92±18. 35, 311. 00±18. 02, 335. 67±19. 91, 280. 83±33. 74, 269. 92 ± 23. 32, 307. 00 ± 28. 40 ) were significantly thicker than the corresponding areas of the normal fellow eyes (220. 51 ± 23. 94, 292. 08 ± 21. 93, 282. 50 ± 20. 30, 288. 33 ± 20. 76, 251. 25±17. 60, 247. 75±21. 48, 265. 17±24. 76ü m) (P<0. 01) with the exception of the lT (291. 58±18. 97, 280. 33± 20.82üm) and OT (250.83±21.21, 242.08±24.02üm) (P>0. 01). ln Stage B, the macular RT in the areas of ll, lN, OS (335.67±19.20,319.75±19.20, 273.50±16.89üm) were significantly thicker than the corresponding areas of the normal fellow eyes (286. 33±20. 46, 293. 42±17. 64, 252. 50± 16.32üm) (P<0. 01). However, the macular RT of the operated eyes in the areas of C, lS, lT, Ol and OT had no statistically significant difference compared with the corresponding areas of the normal fellow eyes (P> 0. 01). ln Stage C, the macular RT of operated eyes with the areas of lN (321. 17 ± 19. 71ü m) were significantly thicker than the corresponding areas of the normal fellow eyes (296.25±19.57üm) (P<0.01). Meanwhile the other areas of the operated eyes were not significantly different from the normal fellow eyes (P>0. 01). Moreover, the macular RT of operated eyes in the areas of ON, lT (307. 00±28. 40, 291. 58 ± 18. 97ü m ) in stage A significantly decreased compared to that of the corresponding areas in stage C (276. 08±32. 39, 278. 75±10. 19ü m) (P<0. 01). <br> CONCLUSlON: SD-OCT is a convenient tool for the observation of macular regional changes after macular hole surgery. Macular RT had persistent changes after vitrectomy on eyes with macular hole by SD-OCT. lLM peeling may have caused microstructural changes in wide areas of the macular region after PPV surgery. More support and evidence were provided to the further study of the long - term observation for the structural and function of macular after macular hole surgery.
