中华眼底病杂志
中華眼底病雜誌
중화안저병잡지
CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
2015年
1期
45-48
,共4页
视网膜穿孔/外科学%视网膜穿孔/药物疗法%玻璃体切除术
視網膜穿孔/外科學%視網膜穿孔/藥物療法%玻璃體切除術
시망막천공/외과학%시망막천공/약물요법%파리체절제술
Retinal perforations/surgery%Retinal perforations/drug therapy%Vitrectomy
目的 观察手术与非手术治疗对外伤性黄斑裂孔愈合及视功能的影响.方法 回顾性分析眼球钝挫伤所致外伤性黄斑裂孔患者47例47只眼的临床资料.其中,男性38例,占80.9％;女性9例,占19.1％.平均年龄(29.6±10.2)岁.根据是否进行手术治疗将患者分为非手术治疗组和手术治疗组,分别为21、26只眼.两组间平均年龄(t=-2.21)、平均视力(Z=-2.72)、平均黄斑裂孔直径(t=-4.76)、合并眼后节损伤构成比(x2=5.46)比较,差异均有统计学意义(P＜0.05).所有患者采用Humphrey OCT-2010型检查仪观察患眼黄斑裂孔情况;GVERIS4.2多焦视网膜电图(mfERG)检测仪观察患眼N1、P1波在中心凹和黄斑区的振幅密度和潜伏时.非手术治疗组给予药物保守治疗.手术治疗组行玻璃体切割、内界膜剥除联合14 ％C3F8气体内加压手术.治疗后随访12个月,采用治疗前相同的设备和方法行相关检查,观察两组患眼黄斑裂孔愈合、视力以及N1、P1波振幅密度、潜伏时改善情况.手术治疗组同时观察与治疗相关的并发症.结果 非手术治疗组21只眼中,黄斑裂孔自行愈合7只眼,占33.3％.平均视力0.27±0.20,与治疗前比较,差异有统计学意义(Z=-2.40,P＜0.05).mfERG检查结果,N1波中心凹、黄斑区振幅密度均较治疗前提高,差异有统计学意义(t=13.30、5.06,P＜0.05);潜伏时与治疗前比较,差异无统计学意义(t=1.68、2.07,P＞0.05).手术治疗组26只眼中,黄斑裂孔愈合18只眼,占69.2％.平均视力0.15±0.07,与手术前平均视力比较,差异无统计有意义(Z=-1.79,P＞0.05).mfERG检查结果,N1波黄斑区振幅密度较治疗前提高6只眼,治疗前后N1波黄斑区振幅密度比较,差异无统计学意义(t=1.98,P＞0.05);N1波黄斑区潜伏时较治疗前延长,差异有统计学意义(t=-7.30,P＜0.05).所有患眼均未发生视网膜脱离等与治疗相关的严重并发症.结论 直径较小的外伤性黄斑裂孔,非手术治疗后部分患眼能够自愈且视功能预后较好;玻璃体切割手术可以提高外伤性黄斑裂孔的愈合率,但视功能改善并不显著.
目的 觀察手術與非手術治療對外傷性黃斑裂孔愈閤及視功能的影響.方法 迴顧性分析眼毬鈍挫傷所緻外傷性黃斑裂孔患者47例47隻眼的臨床資料.其中,男性38例,佔80.9％;女性9例,佔19.1％.平均年齡(29.6±10.2)歲.根據是否進行手術治療將患者分為非手術治療組和手術治療組,分彆為21、26隻眼.兩組間平均年齡(t=-2.21)、平均視力(Z=-2.72)、平均黃斑裂孔直徑(t=-4.76)、閤併眼後節損傷構成比(x2=5.46)比較,差異均有統計學意義(P＜0.05).所有患者採用Humphrey OCT-2010型檢查儀觀察患眼黃斑裂孔情況;GVERIS4.2多焦視網膜電圖(mfERG)檢測儀觀察患眼N1、P1波在中心凹和黃斑區的振幅密度和潛伏時.非手術治療組給予藥物保守治療.手術治療組行玻璃體切割、內界膜剝除聯閤14 ％C3F8氣體內加壓手術.治療後隨訪12箇月,採用治療前相同的設備和方法行相關檢查,觀察兩組患眼黃斑裂孔愈閤、視力以及N1、P1波振幅密度、潛伏時改善情況.手術治療組同時觀察與治療相關的併髮癥.結果 非手術治療組21隻眼中,黃斑裂孔自行愈閤7隻眼,佔33.3％.平均視力0.27±0.20,與治療前比較,差異有統計學意義(Z=-2.40,P＜0.05).mfERG檢查結果,N1波中心凹、黃斑區振幅密度均較治療前提高,差異有統計學意義(t=13.30、5.06,P＜0.05);潛伏時與治療前比較,差異無統計學意義(t=1.68、2.07,P＞0.05).手術治療組26隻眼中,黃斑裂孔愈閤18隻眼,佔69.2％.平均視力0.15±0.07,與手術前平均視力比較,差異無統計有意義(Z=-1.79,P＞0.05).mfERG檢查結果,N1波黃斑區振幅密度較治療前提高6隻眼,治療前後N1波黃斑區振幅密度比較,差異無統計學意義(t=1.98,P＞0.05);N1波黃斑區潛伏時較治療前延長,差異有統計學意義(t=-7.30,P＜0.05).所有患眼均未髮生視網膜脫離等與治療相關的嚴重併髮癥.結論 直徑較小的外傷性黃斑裂孔,非手術治療後部分患眼能夠自愈且視功能預後較好;玻璃體切割手術可以提高外傷性黃斑裂孔的愈閤率,但視功能改善併不顯著.
목적 관찰수술여비수술치료대외상성황반렬공유합급시공능적영향.방법 회고성분석안구둔좌상소치외상성황반렬공환자47례47지안적림상자료.기중,남성38례,점80.9％;녀성9례,점19.1％.평균년령(29.6±10.2)세.근거시부진행수술치료장환자분위비수술치료조화수술치료조,분별위21、26지안.량조간평균년령(t=-2.21)、평균시력(Z=-2.72)、평균황반렬공직경(t=-4.76)、합병안후절손상구성비(x2=5.46)비교,차이균유통계학의의(P＜0.05).소유환자채용Humphrey OCT-2010형검사의관찰환안황반렬공정황;GVERIS4.2다초시망막전도(mfERG)검측의관찰환안N1、P1파재중심요화황반구적진폭밀도화잠복시.비수술치료조급여약물보수치료.수술치료조행파리체절할、내계막박제연합14 ％C3F8기체내가압수술.치료후수방12개월,채용치료전상동적설비화방법행상관검사,관찰량조환안황반렬공유합、시력이급N1、P1파진폭밀도、잠복시개선정황.수술치료조동시관찰여치료상관적병발증.결과 비수술치료조21지안중,황반렬공자행유합7지안,점33.3％.평균시력0.27±0.20,여치료전비교,차이유통계학의의(Z=-2.40,P＜0.05).mfERG검사결과,N1파중심요、황반구진폭밀도균교치료전제고,차이유통계학의의(t=13.30、5.06,P＜0.05);잠복시여치료전비교,차이무통계학의의(t=1.68、2.07,P＞0.05).수술치료조26지안중,황반렬공유합18지안,점69.2％.평균시력0.15±0.07,여수술전평균시력비교,차이무통계유의의(Z=-1.79,P＞0.05).mfERG검사결과,N1파황반구진폭밀도교치료전제고6지안,치료전후N1파황반구진폭밀도비교,차이무통계학의의(t=1.98,P＞0.05);N1파황반구잠복시교치료전연장,차이유통계학의의(t=-7.30,P＜0.05).소유환안균미발생시망막탈리등여치료상관적엄중병발증.결론 직경교소적외상성황반렬공,비수술치료후부분환안능구자유차시공능예후교호;파리체절할수술가이제고외상성황반렬공적유합솔,단시공능개선병불현저.
Objective To analyze the clinical characteristic,treatment and prognosis of traumatic macular holes resulted from ocular contusion.Methods The clinical data of 47 cases with traumatic macular hole was retrospectively reviewed.The general condition of the patients was summarized,optical coherence tomography and multifocal electroretinogram (mfERG) were used to evaluate anatomic and functional outcomes.The patients were divided into observation group and surgery group by the treatment they received,and the prognosis was evaluated.Results Traumatic macular hole occurs mainly in male.In the observation group,the mean diameter of macular hole was(490.0±86.9) μm.During the 12 month follow up,the holes in 7 cases (33.3％) were closed spontaneously,Vision and diameters of 14 cases (57.1％) maintained stable for a long time,the vision of 1 case (3.3 ％) declined mildly and the diameter of 1 case (3.3％) enlarged slightly.Visual acuity was improved significantly at last follow up (Z=-2.40,P＜ 0.05).The amplitudes of N1 wave of mfERG increased both in central fovea and macular area(t=13.30,5.06;P＜0.05).These data suggests that the macular function was recovered well.In the surgery group,the mean diameter of macular hole was (643.3 ± 125.0) μm and statistically larger than that of the observation group (t=-4.76,P＜0.05).At the last follow-up,visual acuity were not improved significantly (Z=-1.79,P＞0.05).The amplitudes of N1 wave in 6 cases (23.1 ％) improved merely and the difference was not statistically significant (t =1.98,P ＞ 0.05).These data suggests that the macular function was recovered slightly only in a few patients.Conclusions A part of the patients with smaller diameters of macular holes may close spontaneously,and they may get better visual acuity.Vitrectomy may help to close the macular holes in some severe cases,but the improvement of functional outcomes is not significant.
