CAJ | 학술논문

目的对累及黄斑区的孔源性视网膜脱离行巩膜扣带术手术成功眼后极部进行OCT扫描,并分析其与术后视力的关系.方法 28例28只眼视网膜脱离已累及黄斑区者,经间接检查眼镜下巩膜外加压术联合或不联合环扎术,视网膜均成功复位,分别于术后1周、1、3、6、12个月行最佳矫正视力、眼底照相、光学相干断层扫描(OCT)检查,并进行统计分析.结果最佳矫正视力提高2行以上者于术后1周、3月、6月、12月分别为53.57％、60.71％、78.57％、85.71％、88.46％,最佳矫正视力(BCVA)术后1周视力较术前明显提高(P=0.001),术后1月与术后1周差异无统计学意义(P=0.124);术后3月与术后1月差异有统计学意义(P=0.033);术后6月与术后3月差异无统计学意义(P=0.206);术后12个月与术后6个月差异无统计学意义(P=0.243),但与术后3个月差异有统计学意义(P=0.011).OCT扫描测量黄斑区神经上皮层厚度+视网膜下液高度于术后1周、1月、3月、6月、12月分别为(507.89±144.37)μm、(389.89±104.47)μm、(298.15±97.35)μm、(264.00±82.26)μm、(230.57±58.71)μm;术后1月与1周(P=0.000)、术后3月与1月(P=0.000)、术后6月与3月(P=0.001)差异均有统计学意义,而术后6月和12月则无明显变化(P=0.088).视网膜神经上皮下积液,随着时间的延长,积液不断吸收,至术后12月时达92.31％视网膜神经上皮下积液完全吸收.结论 OCT能清晰地显示视网膜脱离术后黄斑区微观形态结构的变化,黄斑区解剖复位需要较长时间,可以较好地解释术后视力的恢复过程.
목적 대루급황반구적공원성시망막탈리행공막구대술수술성공안후겁부진행OCT소묘,병분석기여술후시력적관계.방법 28례28지안시망막탈리이루급황반구자,경간접검사안경하공막외가압술연합혹불연합배찰술,시망막균성공복위,분별우술후1주、1、3、6、12개월행최가교정시력、안저조상、광학상간단층소묘(OCT)검사,병진행통계분석.결과 최가교정시력제고2행이상자우술후1주、3월、6월、12월분별위53.57％、60.71％、78.57％、85.71％、88.46％,최가교정시력(BCVA)술후1주시력교술전명현제고(P=0.001),술후1월여술후1주차이무통계학의의(P=0.124);술후3월여술후1월차이유통계학의의(P=0.033);술후6월여술후3월차이무통계학의의(P=0.206);술후12개월여술후6개월차이무통계학의의(P=0.243),단여술후3개월차이유통계학의의(P=0.011).OCT소묘측량황반구신경상피층후도+시망막하액고도우술후1주、1월、3월、6월、12월분별위(507.89±144.37)μm、(389.89±104.47)μm、(298.15±97.35)μm、(264.00±82.26)μm、(230.57±58.71)μm;술후1월여1주(P=0.000)、술후3월여1월(P=0.000)、술후6월여3월(P=0.001)차이균유통계학의의,이술후6월화12월칙무명현변화(P=0.088).시망막신경상피하적액,수착시간적연장,적액불단흡수,지술후12월시체92.31％시망막신경상피하적액완전흡수.결론 OCT능청석지현시시망막탈리술후황반구미관형태결구적변화,황반구해부복위수요교장시간,가이교호지해석술후시력적회복과정.
Objective To observe the macular histomorphological changes and visual acuity(VA)of the macula-Off rhegmatogenous retinal detachment(RRD)with optical coherence tomography(OCT)after scleral buckling.Methods Twenty-eight eyes of 28 patients with macula-off RD underwent best-corrected visual acuity(BCVA)measurement and optical coherence tomography(OCT)scan through the fovea before surgery and 1 week,1,3,6,12 months after the operation.The relationships between images with visual acuity were analyzed.Results The percent of the patients whose BCVA improved 2 lines that 1 week,1,3,6,12 months after the operation was respectively 53.57％,60.71％,78.57％,85.71％,88.46％.There were significantly differences of the BCVA between 1 week and 1 month(P=0.000),1 month and 3 months(P=0.000),6 months and 3 months(P=0.001)after the operation.The retinal neuroepithelial thickness+subretianl fluid that 1 week,1,3,6,12months after the operation were respectively 507.89±144.37μm,389.89±104.47μm,298.15±97.35μm,264.00±82.26μm,230.57±58.71μm.There were significantly difference between 1 week and 1 month(P=0.001),1 month and 3 months(P=0.033),12 months and 3 months after the operation(P=0.011).There were no significantly difference between 6 months and 12 months after the operation(P=0.088).The subretinal fluid was gradually absorbed after surgery.The percent of the patients whose subretinal fluid was completely absorbed was 92.31％.Conclusions OCT can be used to observe the macular histomorphological changes after rhegmatogenous retinal detachment surgery.The macula reattachment completely and the visual acuity may be needed more time for recovering.