[1]万敏婕,杨先凤.SD-OCT及FFA在白内障术后黄斑囊样水肿研究中的应用[J].眼科新进展,2015,35(1):055-59.[doi:10.13389/j.cnki.rao.2015.0016]
　WAN Min-Jie,YANG Xian-Feng.Evaluation of cystoid macular edema using optical coherence tomography and fundus fluorescein angiography after cataract surgery[J].Recent Advances in Ophthalmology,2015,35(1):055-59.[doi:10.13389/j.cnki.rao.2015.0016]
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SD-OCT及FFA在白内障术后黄斑囊样水肿研究中的应用
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
35卷
期数:
2015年1期
页码:
055-59
栏目:
应用研究
出版日期:
2015-01-05

文章信息/Info

Title:
Evaluation of cystoid macular edema using optical coherence tomography and fundus fluorescein angiography after cataract surgery
作者:
万敏婕; 杨先凤
４４３００３　湖北省宜昌市，三峡大学第一临床医学院、湖北省宜昌市中心人民医院眼科
Author(s):
WAN Min-Jie ;  YANG Xian-Feng
First College of Clinical Medical Science , China Three Gorges University , Department of Ophthalmology , Yichang Central People ’s Hospital, Yichang 443003 , Hubei Province . China
关键词:
超声乳化术; 黄斑囊样水肿; 光学相干断层扫描; 眼底荧光血管造影
Keywords:
phacoemulsification;  cystoid macular edema;  optical coherence tomography ;  fundus fluorescern angiography
DOI:
10.13389/j.cnki.rao.2015.0016
文献标志码:
A
摘要:
目的　探讨谱域光学相干断层扫描（ｓｐｅｃｔｒａｌｄｏｍａｉｎｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ，ＳＤＯＣＴ）和眼底荧光血管造影（ｆｕｎｄｕｓｆｌｕｏｒｅｓｃｅｉｎａｎｇｉｏｇｒａｐｈｙ，ＦＦＡ）检测白内障术后黄斑中心凹厚度及黄斑中心凹旁视网膜水肿的情况，指导白内障术后黄斑囊样水肿的诊断及治疗。方法　对２０１２年５月至２０１３年９月在我院行白内障手术的患者８８例（９１眼）进行临床观察。术前及术后１周、４周、１２周及２４周分别进行详细眼底检查，ＳＤＯＣＴ测量黄斑中心凹厚度及黄斑中心凹旁上方、下方、鼻侧、颞侧视网膜厚度。同时运用ＬｏｇＭＡＲ表行最佳矫正视力（ｂｅｓｔｃｏｒｒｅｃｔｅｄｖｉｓｕａｌａｃｕｉｔｙ，ＢＣＶＡ）检查。术后较术前黄斑中心凹厚度大３个标准偏差表示存在ＣＭＥ，在术后１２周行ＦＦＡ检查。相关资料运用ＳＰＳＳ１７．０进行统计学分析。结果　术前患者黄斑中心凹厚度为（２５４．６８±２２０４）μｍ，术后１周、４周、１２周、２４周黄斑中心凹厚度分别为（２６４．５２±２３．２７）μｍ、（２６２．５１±２４．６４）μｍ、（２６７．５２±３９．１４）μｍ、（２６３．７１±２６．５８）μｍ，均较术前增加，差异均有统计学意义（均为Ｐ＜０．０５），增加最明显的是术后１２周时（Ｐ＝００２８），术后１２周时颞侧、鼻侧、上方及下方的黄斑中心凹旁视网膜厚度均较术前显著增加（均为Ｐ＜０．０１）。术后１周、４周黄斑中心凹厚度的改变与ＢＣＶＡ无明显相关性，但术后１２周、２４周时黄斑中心凹厚度的改变与ＢＣＶＡ有显著相关性（均为Ｐ＝０００）。术后１２周通过ＦＦＡ检测的黄斑囊样水肿的发生率为３．３％，而通过ＳＤＯＣＴ检测的发生率为５．５％。结论　白内障术后患者黄斑区视网膜厚度有明显改变，ＳＤＯＣＴ能准确观察白内障术后早期黄斑区视网膜厚度的增加及黄斑囊样水肿的形态特点。ＳＤＯＣＴ观察白内障术后黄斑囊样水肿的情况与ＦＦＡ的结果并非完全一致。
Abstract:
Objective To investigate the central macular thickness ( CMT) and perifoveal macular edema to guide the diagnosis and treatment of cystoid macular edema ( CME) after phacoemulsification surgery. Methods Ninety-one eyes of 88 patients who underwent phacoemulsification surgery between May 2012 and September 2013 were included in the study. Ocular fundus exanunations and spectral domain optical coherence tomography ( SD-OCT) measurements were performed preoperation and at postoperative I week, 4 weeks , 12 weeks , and 24 weeks. Mean CMT and perifoveal macular thickness in superior, inferior. nasal and temporal quadrants were recorded. Best corrected visual acuity ( BCVA) was measured as logMAR units at preoperative and all postoperative visits. CME was defined as three standard deviations ( SD) above the preoperative mean CMT in OCT measurements. Fundus fluorescein angiography ( FFA) was performed at postoperative 12 weeks. Data were analyzed statistically by SPSS 17. 0. Results The preoperative CMT was ( 254. 68 + 22. 04) Vm, which at postoperative I week ,4 weeks . 12 weeks . and 24 weeks were ( 264. 52 + 23. 27 ) Vm , ( 262. 51 + 24. 64 ) ym , ( 267. 52 + 39. 14) ym and ( 263. 71 + 26. 58 ) ym , respectively , there were statistical differences ( all P < 0. 05 ). The most significant increase in CMT was seen at postoperative 12 weeks (P = 0. 028 ) . The changes in perifoveal macular thickness measurements in the temporal, nasal, superior and inferior quadrant was statistically significant at postoperative 12 weeks ( all P < 0. 01 ) . The increase in macular thickness did not correlated with BCVA at postoperative I week and 4 weeks , but there was a sigruficant correlation at postoperative 12 weeks and 24 weeks ( all P = 0. 00) . The incidence of angiographic CME observed by FFA at postoperative 12 weeks was 3. 3% , but which observed by SD-OCT was 5. 5% . Conclusion Macular thickness changes after uncomplicated phacoemulsification surgery , SD-OCT is helpful in detecting cystoid abnormalities and any increase in macular thickness at postoperative early periods. Changes seen on OCT do not completely sinular with FFA findings.

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更新日期/Last Update: 2015-01-04