CAJ | 학술논문

目的观察玻璃体切割手术眼内灌注液中肾上腺素对手术后视网膜血管管径和黄斑厚度的影响.方法前瞻性临床对照研究.行玻璃体切割手术的黄斑裂孔患者32例32只眼纳入研究.其中,男性14例14只眼,女性18例18只眼.平均年龄(64.0±4.5)岁.所有患者手术前后均行裸眼视力、矫正视力、裂隙灯显微镜、间接检眼镜、眼底彩色照相、光相干断层扫描(OCT)检查.手术前1周,采用同一像素标准采集同一患眼以视盘为中心的彩色眼底像1张.应用IVON计算机图像分析软件,测量距视盘边缘0.5～1.0个视盘直径范围内所有可测量的小动脉和小静脉.测量结果以视网膜中央动脉等效管径(CRAE)、视网膜中央静脉等效管径(CRVE)表示.以黄斑区视网膜内界面与视网膜色素上皮间的距离为黄斑厚度.按照距黄斑中心凹＜3、3～6 mm距离将黄斑分为黄斑内环、外环.根据玻璃体灌注液中是否含有肾上腺素,将患眼分为肾上腺素组、无肾上腺素组,每组均为1 6只眼.肾上腺素组眼内灌注液中肾上腺素浓度为1:1000.肾上腺素组、无肾上腺素组患眼CRAE、CRVE比较,差异无统计学意义(P＞0.05);黄斑内环、外环厚度比较,差异无统计学意义(P＞0.05).手术后平均随访时间3.5个月.对比观察手术前与手术后1、3个月患眼CRAE、CRVE,黄斑内环、外环厚度变化.结果手术后1、3个月,肾上腺素组患眼CRAE(t=0.322、0.148)、CRVE(t=0.317、0.005)与手术前比较,差异均无统计学意义(P＞0.05);无肾上腺素组患眼CRAE(t=0.226、0.137)、CRVE(t-0.284、0.151)与手术前比较,差异均无统计学意义(P＞0.05).两组患眼间CRAE(t=0.624、0.424)、CRVE(t=0.015、0.041)比较,差异均无统计学意义(P＞0.05).肾上腺素组患眼黄斑内环(t=0.322、0.148)、外环(t=0.317、0.005)厚度与手术前比较,差异均无统计学意义(P＞0.05);无肾上腺素组患眼黄斑内环(t=0.226、0.137)、外环(t=0.284、0.151)厚度与手术前比较,差异均无统计学意义(P＞0.05).两组患眼间黄斑内环(t=1.568、0.373)、外环(t=1.697、0.536)厚度比较,差异均无统计学意义(P＞0.05).结论玻璃体切割手术眼内灌注液中1:1000肾上腺素浓度对黄斑裂孔患者手术后视网膜血管管径、黄斑厚度无明显影响. 目的觀察玻璃體切割手術眼內灌註液中腎上腺素對手術後視網膜血管管徑和黃斑厚度的影響.方法前瞻性臨床對照研究.行玻璃體切割手術的黃斑裂孔患者32例32隻眼納入研究.其中,男性14例14隻眼,女性18例18隻眼.平均年齡(64.0±4.5)歲.所有患者手術前後均行裸眼視力、矯正視力、裂隙燈顯微鏡、間接檢眼鏡、眼底綵色照相、光相榦斷層掃描(OCT)檢查.手術前1週,採用同一像素標準採集同一患眼以視盤為中心的綵色眼底像1張.應用IVON計算機圖像分析軟件,測量距視盤邊緣0.5～1.0箇視盤直徑範圍內所有可測量的小動脈和小靜脈.測量結果以視網膜中央動脈等效管徑(CRAE)、視網膜中央靜脈等效管徑(CRVE)錶示.以黃斑區視網膜內界麵與視網膜色素上皮間的距離為黃斑厚度.按照距黃斑中心凹＜3、3～6 mm距離將黃斑分為黃斑內環、外環.根據玻璃體灌註液中是否含有腎上腺素,將患眼分為腎上腺素組、無腎上腺素組,每組均為1 6隻眼.腎上腺素組眼內灌註液中腎上腺素濃度為1:1000.腎上腺素組、無腎上腺素組患眼CRAE、CRVE比較,差異無統計學意義(P＞0.05);黃斑內環、外環厚度比較,差異無統計學意義(P＞0.05).手術後平均隨訪時間3.5箇月.對比觀察手術前與手術後1、3箇月患眼CRAE、CRVE,黃斑內環、外環厚度變化.結果手術後1、3箇月,腎上腺素組患眼CRAE(t=0.322、0.148)、CRVE(t=0.317、0.005)與手術前比較,差異均無統計學意義(P＞0.05);無腎上腺素組患眼CRAE(t=0.226、0.137)、CRVE(t-0.284、0.151)與手術前比較,差異均無統計學意義(P＞0.05).兩組患眼間CRAE(t=0.624、0.424)、CRVE(t=0.015、0.041)比較,差異均無統計學意義(P＞0.05).腎上腺素組患眼黃斑內環(t=0.322、0.148)、外環(t=0.317、0.005)厚度與手術前比較,差異均無統計學意義(P＞0.05);無腎上腺素組患眼黃斑內環(t=0.226、0.137)、外環(t=0.284、0.151)厚度與手術前比較,差異均無統計學意義(P＞0.05).兩組患眼間黃斑內環(t=1.568、0.373)、外環(t=1.697、0.536)厚度比較,差異均無統計學意義(P＞0.05).結論玻璃體切割手術眼內灌註液中1:1000腎上腺素濃度對黃斑裂孔患者手術後視網膜血管管徑、黃斑厚度無明顯影響.
목적 관찰파리체절할수술안내관주액중신상선소대수술후시망막혈관관경화황반후도적영향.방법 전첨성림상대조연구.행파리체절할수술적황반렬공환자32례32지안납입연구.기중,남성14례14지안,녀성18례18지안.평균년령(64.0±4.5)세.소유환자수술전후균행라안시력、교정시력、렬극등현미경、간접검안경、안저채색조상、광상간단층소묘(OCT)검사.수술전1주,채용동일상소표준채집동일환안이시반위중심적채색안저상1장.응용IVON계산궤도상분석연건,측량거시반변연0.5～1.0개시반직경범위내소유가측량적소동맥화소정맥.측량결과이시망막중앙동맥등효관경(CRAE)、시망막중앙정맥등효관경(CRVE)표시.이황반구시망막내계면여시망막색소상피간적거리위황반후도.안조거황반중심요＜3、3～6 mm거리장황반분위황반내배、외배.근거파리체관주액중시부함유신상선소,장환안분위신상선소조、무신상선소조,매조균위1 6지안.신상선소조안내관주액중신상선소농도위1:1000.신상선소조、무신상선소조환안CRAE、CRVE비교,차이무통계학의의(P＞0.05);황반내배、외배후도비교,차이무통계학의의(P＞0.05).수술후평균수방시간3.5개월.대비관찰수술전여수술후1、3개월환안CRAE、CRVE,황반내배、외배후도변화.결과 수술후1、3개월,신상선소조환안CRAE(t=0.322、0.148)、CRVE(t=0.317、0.005)여수술전비교,차이균무통계학의의(P＞0.05);무신상선소조환안CRAE(t=0.226、0.137)、CRVE(t-0.284、0.151)여수술전비교,차이균무통계학의의(P＞0.05).량조환안간CRAE(t=0.624、0.424)、CRVE(t=0.015、0.041)비교,차이균무통계학의의(P＞0.05).신상선소조환안황반내배(t=0.322、0.148)、외배(t=0.317、0.005)후도여수술전비교,차이균무통계학의의(P＞0.05);무신상선소조환안황반내배(t=0.226、0.137)、외배(t=0.284、0.151)후도여수술전비교,차이균무통계학의의(P＞0.05).량조환안간황반내배(t=1.568、0.373)、외배(t=1.697、0.536)후도비교,차이균무통계학의의(P＞0.05).결론 파리체절할수술안내관주액중1:1000신상선소농도대황반렬공환자수술후시망막혈관관경、황반후도무명현영향.
Objective To observe the effect of epinephrine in intraocular irrigation solution on retinal vascular caliber and macular thickness.Methods A prospective control study.32 eyes of 32 patients with macular hole who underwent vitrectomy were enrolled in this study.The patients including 14 males (14 eyes) and 27 females (18 eyes), with the average age of (64.0 ± 4.5)years.Uncorrected visual acuity,corrected visual acuity, slit lamp biomicroscopy, indirect ophthalmoscopy, fundus color photography and optical coherence tomography were performed in all patients.Retinal vascular caliber located in 0.5-1.0) disc diameter from optic disk was measured from digital fundus photographs and summarized as central retinal artery (CRAE) and vein (CRVE) equivalents in all eyes at baseline and at the 1 month, 3 months follow-up visit.The macular thickness is the distance from retinal interface of inner plexiform layer to retinal pigment epithelium layer.The macula was divided into inner ring (＜3 mm) and outer ring (3-6 mm) according to the distance from the fovea.The patients were divided into experiment group (include epinephrine in intraocular irrigation solution, 1:1000) and control group (without epinephrine in intraocular irrigation solution), 16 eyes in each group.The difference of CRAE and CRVE between two groups was not significant (P＞ 0.05).The difference of macular thickness between inner ring and outer ring was not significant (P＞0.05).The average follow-up was 3.5 months.CRAE, CRVE and macular thickness in inner ring and outer ring before and 1 month, 3 months after surgery were comparatively analyzed.Results The differences of CRAE and CRVE before and 1, 3 months after surgery both in experiment group (tCRAE=0.322, 0.148;tCRVE=0.317,0.005) and control group (tCRAE =0.226,0.137;tCRVE =0.284,0.151) were not significant (P＞0.05).The differences of CRAE (t =0.624,0.424) and CRVE (t=0.015,0.041) between experiment group and control group also were not significant (P ＞ 0.05).The differences of macular thickness in inner ring and outer ring before and 1, 3 months after surgery both in experiment group (tinner=0.322,0.148;t =0.317,0.005) and control group (ti =0.226,0.137;t =0.284,0.151) were not significant (P＞0.05).The differences of macular thickness in inner ring (t=1.568, 0.373) and outer ring (t =-1.697,0.536) between experiment group and control group also were not significant (P＞0.05).Conclusion Epinephrine (1:1000) in intraocular irrigation solution has no effect on retinal vascular caliber and macular thickness in patients with macular hole.