黄斑部视网膜前膜患者手术前后黄斑区结构变化及与视功能预后的关系

目的:探讨黄斑部视网膜前膜患者手术前后黄斑区域结构变化情况,及其与患者术后视功能的关系。方法:对2014年2月-2016年8月间在我院进行手术治疗的黄斑部视网膜前膜患者60例(60眼)的临床资料进行回顾性分析。所有患者均进行光学相干断层扫描(OCT)检查,观察黄斑中心凹及各方位视网膜厚度变化,同时记录患者手术前后最佳矫正视力(BCVA),分析其相关性。结果:术后53例(53眼)患者视力提高,占88.33%,7例(7眼)患者视力不变,占11.67%。术前患者BCVA为(0.18±0.07),术后3个月BCVA为(0.38±0.12),术后3个月BCVA较术前显著提高(P0.05)。患者术后黄斑中心凹厚度、内环颞侧厚度、内环鼻侧厚度、内环上方厚度、内环下方厚度、外环颞侧厚度、外环鼻侧厚度、外环上方厚度、外环下方厚度较术前均显著降低,差异具有统计学意义(P0.05)。经Pearson相关分析显示,患者术前黄斑中心凹厚度、内环颞侧厚度、外环颞侧厚度、术前后黄斑中心凹厚度差值、术前后内环颞侧厚度差值、术前后外环颞侧厚度差值与术后BCVA呈负相关(P0.05)。结论:玻璃体切除术可以显著降低黄斑部视网膜前膜患者黄斑区视网膜厚度,提高患者视功能,术前黄斑区域形态对患者术后视力恢复有一定影响。

Relationship between Macular Structure Changes and Prognosis of Visual Function in Patients with Macular Epiretinal Membrane before and after Operation

ABSTRACT Objective: To investigate the changes of macular region structure before and after operation in patients with macular epiretinal membrane, and its relationship with the visual function of patients. Methods: The clinical data of 60 patients with macular epiretinal membrane (60 eyes) in our hospital from February 2014 to August 2016 were retrospectively analyzed. All patients were exam- ined with optical coherence tomography (OCT) examination, and observed the changes of macula central fovea and retinal each azimuth thickness, and the best corrected visual acuity (BCVA) was recorded before and after operation,and the correlations of them were analy- sised. Results: The visual acuity was improved in 53 patients (53 eyes) after operation, accounting for 88.33%, and the visual acuity was unchanged in 7 patients (7 eyes), accounting for 11.67%. The preoperative BCVA of patients was (0.18±0.07), and it was (0.38±0.12) at 3 months after operation, which was significantly higher than before operation (P<0.05). Postoperative macular central thickness, inner side of the inner ring thickness, nasal side of the inner ring thickness, above the inner ring thickness, below the inner ring thickness, outer ring temporal side thickness, external ring nasal side thickness, above the outer ring thickness, below the outer ring thickness in patients compared with the preoperative were significantly lower, the difference was statistically significant (P<0.05). The Pearson correlation analysis showed that preoperative macular central thickness, preoperative inner side of the inner ring thickness, preoperative outer ring temporal side thickness, the difference of macular fovea thickness before and after operation, the difference of the medial temporal before and after operationwas, the difference of outer ring temporal side before and after operation were negatively correlated with postoperative BCVA(P<0.05). Conclusion: Vitrectomy can significantly reduce macular retinal thickness in patients with macular epiretinal mem- brane, and it can improve the visual function of patients, and the shape of macular region before operation had some influence on postop- erative visual acuity.