[1]赵婷婷,周民稳,施靖容,等.特发性黄斑前膜术后黄斑区结构改变与视功能的相关性[J].眼科新进展,2016,36(6):536-539.[doi:10.13389/j.cnki.rao.2016.0142]
　ZHAO Ting-Ting,ZHOU Min-Wen,SHI Jing-Rong,et al.Correlation between macular structure and visual function after idiopathic epiretinal membrane surgery[J].Recent Advances in Ophthalmology,2016,36(6):536-539.[doi:10.13389/j.cnki.rao.2016.0142]
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特发性黄斑前膜术后黄斑区结构改变与视功能的相关性
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
36卷
期数:
2016年6期
页码:
536-539
栏目:
应用研究
出版日期:
2016-06-05

文章信息/Info

Title:
Correlation between macular structure and visual function after idiopathic epiretinal membrane surgery
作者:
赵婷婷; 周民稳; 施靖容; 陈秋莹; 何玉萍; 樊莹
200080　上海市，上海交通大学附属第一人民医院眼科
Author(s):
ZHAO Ting-Ting ; ZHOU Min-Wen ;  SHI Jing-Rong ;  CHEN Qiu-Ying;  HE Yu-Ping ;  FAN Ying
Department of Ophthalmology , Shanghai First Hospital , Shanghai Jiaotong University School of Medicine , Shanghai 200080 , China
关键词:
特发性黄斑前膜; 黄斑中心凹厚度; 最佳矫正视力
Keywords:
idiopathic macular membrane ;  macular fovea thickness ;  best corrected visual acuity
DOI:
10.13389/j.cnki.rao.2016.0142
文献标志码:
A
摘要:
目的　探讨特发性黄斑前膜患者内界膜剥除术后黄斑区解剖结构的变化及其对视功能的影响。方法　回顾性分析３３例（３３眼）连续治疗的特发性黄斑前膜患者的临床资料，所有患者接受玻璃体切割联合内界膜剥除术，手术前后进行完善的眼科检查：最佳矫正视力、眼压、眼轴、裂隙灯、光学相干断层扫描、眼底照相。海德堡频谱ＯＣＴ九个部位扫描分析黄斑中心凹及中心凹旁结构变化与视功能的相关性，术后视功能的影响因素，ＲＯＣ曲线进一步探讨术前黄斑中心凹厚度评估术后最佳矫正视力的准确性。结果　术后黄斑区内外环各四部分及中心凹视网膜厚度术后较术前均显著降低，以内环颞侧厚度变化较明显，由（４７２．１５±１０２．００）μｍ降至（３２８．０６±５３．７７）μｍ，差异有显著统计学意义（Ｐ＜０．００１）。术后最佳矫正视力０．６３±０．２９，较术前０．２３±０．１６明显提升（Ｐ＜０．００１）。术前黄斑中心凹厚度（ｒ＝－０．５９４，Ｐ＝０．００１）、内环颞侧厚度（ｒ＝－０．６２５，Ｐ＜０．００１）、外环颞侧厚度（ｒ＝－０．５２９，Ｐ＝０．００６）等与术后最佳矫正视力呈负相关。受试者工作特征曲线结果（面积＝０．８５，Ｐ＝０．００１，９５％ＣＩ：０．７２～０．９９）对术前黄斑中心凹厚度评估术后最佳矫正视力的准确性有一定参考价值。结论　玻璃体切割联合内界膜剥除手术可以显著降低特发性黄斑前膜患眼黄斑区视网膜厚度，提高视功能。术前黄斑中心凹形态以及中心凹旁颞侧的形态结构改变对术后视力会产生一定影响。
Abstract:
Objective To investigate the effects of idiopathic epiretinal membrane surgery on visual function and macular structure. Methods Thirty - three patients ( 33 eyes) with idiopathic epiretinal membrane after vitrectomy and internal limiting membrane peeling were enrolled in our retrospective study. Comprehensive ophthalmic examinations ( best corrected visual acuity , intraocular pressure , axial length , slit lamp examination, optical coherence tomography, fundus photography) were conducted. Changes of macular fovea structure and function before and after surgery were compared by Heidelberg spectral-spectrum OCT nine-part scan . and the influencing factors on postoperative visual function were analyzed. Moreover . the accuracy of preoperative foveal thickness evaluating postoperative best corrected visual acuity was further analyzed by receiver operating characteristic curve. Results The postoperative retinal thickness in four parts of inner and outer rings and fovea were decreased after surgery, especially the inner temporal. decreased from (472. 15 + 102. 00) ym to ( 328.06 + 53. 77) ym, the difference was statistically significant ( P < 0. 001 ) . The postoperative best corrected visual acuity ( 0. 63 + 0. 29 ) was significantly improved compared to the preoperative (0. 23 + 0. 16 ) ( P < 0. 001 ) . Preoperative macular central thickness ( r = - 0. 594 ,P = 0. 001) .inner temporal thickness ( r = - 0. 625 .P < 0. 001 ) . and outer temporal thickness ( r = - 0. 529 .P = 0. 006) were negatively correlated with the postoperative best corrected visual acuity. Results of receiver operating characteristic curve ( area = 0. 85 .P =0. 001 ,95% CI:O. 72 - 0. 99) had a certain reference value to the accuracy of preoperative foveal thickness for evaluating the postoperative best corrected visual acuity. Conclusion Vitrectomy combined internal limiting membrane peeling can reduce the macular retinal thickness and improve visual function of patients with idiopathic epiretinal membrane sigruficantly. The morphology and structure at fovea and inner temporal can ir?óUuence the postoperative visual acuity in a certain degree.

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备注/Memo

备注/Memo:
国家重点基础研究发展计划（９７３计划）项目（编号：２０１１ＣＢ７０７５００）
更新日期/Last Update: 2016-06-27