[1]黄定国,黄惠春,张安琳,等.频域OCT观察两种类型视网膜脱离术后黄斑中心凹结构变化[J].眼科新进展,2016,36(12):1176-1179.[doi:10.13389/j.cnki.rao.2016.0313]
　HUANG Ding-Guo,HUANG Hui-Chun,ZHANG An-Lin,et al.Changes in foveal microstructure after surgery for two types of retinal detachment with spectral-domain OCT[J].Recent Advances in Ophthalmology,2016,36(12):1176-1179.[doi:10.13389/j.cnki.rao.2016.0313]
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频域OCT观察两种类型视网膜脱离术后黄斑中心凹结构变化
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
36卷
期数:
2016年12期
页码:
1176-1179
栏目:
应用研究
出版日期:
2016-12-05

文章信息/Info

Title:
Changes in foveal microstructure after surgery for two types of retinal detachment with spectral-domain OCT
作者:
黄定国; 黄惠春; 张安琳; 陈伟奇
515041　广东省汕头市，汕头大学·香港中文大学联合汕头国际眼科中心
Author(s):
HUANG Ding-Guo; HUANG Hui-Chun; ZHANG An-Lin; CHEN Wei-Qi
Department of the Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou 515041 ,Guangdong Province,China
关键词:
频域光学相干断层扫描; 视网膜脱离; 脉络膜脱离; 视网膜中心凹厚度
Keywords:
spectral-domain optical coherence tomography;  retinal detachment;  choroidal detachment ;  foveal thickness
分类号:
Ｒ７７４.１
DOI:
10.13389/j.cnki.rao.2016.0313
文献标志码:
A
摘要:
目的　利用频域光学相干断层扫描（ｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ，ＯＣＴ）观察单纯视网膜脱离（ｒｈｅｇｍａｔｏｇｅｎｏｕｓｒｅｔｉｎａｌｄｅｔａｃｈｍｅｎｔ，ＲＲＤ）和视网膜脱离合并脉络膜脱离（ｒｈｅｇｍａｔｏｇｅｎｏｕｓｒｅｔｉｎａｌｄｅｔａｃｈｍｅｎｔａｓｓｏｃｉａｔｅｄｗｉｔｈｃｈｏｒｏｉｄａｌｄｅｔａｃｈｍｅｎｔ，ＲＲＤＣＤ）术后黄斑中心凹结构的变化，并分析中心凹结构与术后最佳矫正视力的相关性。方法　７７例（７７眼）视网膜脱离患者纳入研究，其中ＲＲＤ组４４例（４４眼），ＲＲＤＣＤ组３３例（３３眼），所有患者均接受玻璃体切割联合硅油填充复位视网膜，利用频域ＯＣＴ观察术后黄斑区光感受器内／外节（ｐｈｏｔｏｒｅｃｅｐｔｏｒｉｎｎｅｒａｎｄｏｕｔｅｒｓｅｇｍｅｎｔ，ＩＳ／ＯＳ）连接带及外界膜（ｅｘｔｅｒｎａｌｌｉｍｉｔｉｎｇｍｅｍｂｒａｎｅ，ＥＬＭ）的形态、视网膜中心凹厚度，分析两组间中心凹形态变化差异，并分析ＩＳ／ＯＳ连接带与ＥＬＭ形态以及视网膜中心凹厚度与术后最佳矫正视力的相关性。结果　两组间的ＩＳ／ＯＳ连接带形态差异有统计学意义（χ２＝６．８８８，Ｐ＝０．０３２），ＲＲＤＣＤ组ＩＳ／ＯＳ连接带的形态消失率明显高于ＲＲＤ组；两组间ＥＬＭ形态差异无统计学意义（χ２＝３．５９７，Ｐ＝０．１６６），两组的ＩＳ／ＯＳ连接带及ＥＬＭ形态的完整性均与术后最佳矫正视力有相关性（ＲＲＤ组：ｒ＝０．６４９、Ｐ＜０．０５，ｒ＝０．４６６、Ｐ＜０．０５；ＲＲＤＣＤ组ｒ＝０．４８０、Ｐ＜０．０５，ｒ＝０．４４２、Ｐ＝０．０１０）。结论　频域ＯＣＴ是一种评价视网膜脱离复位术后黄斑微结构改变的有效手段。ＲＲＤＣＤ的ＩＳ／ＯＳ连接带消失率明显高于ＲＲＤ，这也是提示术后视力较差的原因之一，ＩＳ／ＯＳ连接带及ＥＬＭ形态的完整性可能是预测视网膜脱离复位术后视力恢复的重要因素。
Abstract:
Objective To study the foveal microstructural changes of thegmatogenous retinal detachment ( RRD) and thegmatogenous retinal detachment associated with choroidal detachment ( RRDCD) after surgery by spectral-domain optical coherence tomography ( SD-OCT) ,and deternune its association with visual outcomes. Methods Forty-four patients with RRD and 33 patients with RRDCD were included in this study. All the patients underwent vitrectomy combined silicone oil tamponade. The following postoperative foveal microstructures were evaluated by SD-OCT:photoreceptor inner/outer segment (IS/OS) junction,external linuting membrane ( ELM) and foveal thickness. The correlation between the postoperative best-corrected visual acuity ( BCVA) and microstructural findings at the fovea was evaluated,and the differences of foveal microstructure between the two groups were assessed at the same time. Results There was significant difference in IS/OS junction stage between the two groups (X2 = 6. 888,P = 0. 032). The absent rate of the photoreceptor IS/OS junction in RRDCD group was higher than that in RRD group,however,there was no difference in ELM stage between the two groups (X2 = 3. 597 ,P = 0. 166) ,and the postoperative BCVA was significantly correlated with the integrity of the photoreceptor IS/OS junction and ELM signals detected by SDOCT postoperatively in two groups ( RRD group:r = 0. 649,P < 0. 05 ;r = 0. 466,P < 0. 05. RRDCD group :r = 0. 480 ,P < 0. 05 ; r = 0. 442 ,P = 0. 010 ,respectively) . Conclusion SDOCT is a valuable tool for evaluating foveal microstructural changes after retinal detachment repair.The absent rate of the photoreceptor IS/OS junction in RRDCD group was significantly higher than that in RRD group,which may account for poor prognosis for patients with RRDCD. IS/OS junction and ELM integrity may be important predictors of postoperative visual outcome after anatomically successful RRD surgery.

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更新日期/Last Update: 2016-12-19