光相干断层成像在特发性黄斑前膜患者视功能评估中的应用
|
摘要
目的探讨特发性黄斑前膜(IMEM)患者光相干断层成像(OCT)显示视网膜结构变异程度及黄斑区视网膜厚度(RT)与患者视功能损害的相关性。方法回顾性分析经OCT检查确诊IMEM共56例66眼,进行最佳矫正视力(BCVA)、眼底及OCT检查,依据视网膜内部结构变异严重程度分为轻、中、重度组,并测量RT。结果轻、中、重度组患眼平均RT分别为(311.95±51.78)μm、(447.13±41.95)μm和(560.00±58.23)μm,依次增高,差异有统计学意义(均P<0.05);轻、中、重度组患眼平均BCVA分别为0.78±0.16、0.38±0.12和0.27±0.14,依次降低,差异有统计学意义(P<0.05);轻度组患眼RT与BCVA之间无线性相关性(r=-0.352,P=0.128),中、重度组内患眼RT与BCVA之间呈负相关(r分别为-0.768和-0.482,P<0.05)。结论黄斑区视网膜结构变异程度及RT可以反映视功能损害的程度,RT值达到400μm可以作为手术干预的客观标准。
Objective To investigate the correlation between retinal deformation degree and retina thickness(RT)detected by optic coherent tomography(OTC) in patients with idiopathic macular epiretinal membrane(IMEM).Methods The 66 eyes(56 patients) with IMEM diagnosed by OCT were retrospectively analyzed in this study.After best correctedvisual acuity(BCVA),ocular fundus and OCT examination,patients were divided into three groups(mild,medium andsevere) according to retinal deformation degrees.The RT value was measured manually.Results There were significantdifferences in RT values between mild,moderate and severe groups:(311.95 ±51.78) μm,(447.13±41.95) μm and(560.00±58.23) μm(P<0.05).The values of BCVA were 0.78±0.16,0.38±0.12 and 0.27±0.14 for mild,moderate and severe groups,there were significant differences between them(P<0.05).There was no significant correlation between RT and BCVA inmild group(r=-0.352,P=0.128).There was negative correlation between RT and BCVA in medium group and serious group(r=-0.768 and-0.482,P<0.05).Conclusion The retinal deformation degree and RT are two objective indicators to assessvisual performance in patients of IMEM.When RT is more than 400 μm,it can be used as objective criteria for surgicalintervention.
Objective To investigate the correlation between retinal deformation degree and retina thickness(RT)detected by optic coherent tomography(OTC) in patients with idiopathic macular epiretinal membrane(IMEM).Methods The 66 eyes(56 patients) with IMEM diagnosed by OCT were retrospectively analyzed in this study.After best correctedvisual acuity(BCVA),ocular fundus and OCT examination,patients were divided into three groups(mild,medium andsevere) according to retinal deformation degrees.The RT value was measured manually.Results There were significantdifferences in RT values between mild,moderate and severe groups:(311.95 ±51.78) μm,(447.13±41.95) μm and(560.00±58.23) μm(P<0.05).The values of BCVA were 0.78±0.16,0.38±0.12 and 0.27±0.14 for mild,moderate and severe groups,there were significant differences between them(P<0.05).There was no significant correlation between RT and BCVA inmild group(r=-0.352,P=0.128).There was negative correlation between RT and BCVA in medium group and serious group(r=-0.768 and-0.482,P<0.05).Conclusion The retinal deformation degree and RT are two objective indicators to assessvisual performance in patients of IMEM.When RT is more than 400 μm,it can be used as objective criteria for surgicalintervention.
引文
[1]Mc Carty DJ,Mukesh BN,Chikani V,et al.Prevalence and associationsof epiretinal membranes in the visual impairment project[J].Am JOphthalmol,2005,140(2):288-294.
[2]Mitehell P,Smith W,Chey T,et al.Prevalence and associations of epiretinal membranes.The Blue Mountain Eye Study Australia[J].Ophthalmology,1997,104(6):1033-1040.
[3]Miyazaki M,Nakamura H,Kubo M,et al.Prevalence and riskfactors for epiretinal membranes in a Japanese population:theHisayama study[J].Graefes Arch Clin Exp Ophthalmol,2003,241(8):642-646.
[4]Hikichi T,Trempe CL.Risk of bilateral idiopathic preretinalmacular fibrosis[J].Eye,1995,9(Pt1):64-66.
[5]Liu X,Ling YL,Zheng XP.Optical coherence tomography of idiopathicmacular epiretinal membranes[J].Chin J Ocul Fundus Dis,2001,17(2):115-118.[刘杏,凌运兰,郑小平.特发性黄斑视网膜前膜的光学相干断层扫描[J].中华眼底病杂志,2001,17(2):115-118].
[6]Wise GN.Clinical features of idiopathic preretinal macular fibrosis.Schoenberg Lecture[J].Am J Ophthalmol,1975,79(3):349-357.
[7]Hajnajeeb B,Georgopoulos M,Sayegh R,et al.The role of theoptical coherence tomography in identifying shape and size ofidiopathicepiretinal membranes[J].Br J Ophthalmol,2012,96(6):867-871.doi:10.1136/bjophthalmol-2011-300629.
[8]Okamoto F,Sugiura Y,Okamoto Y,et al.Associations between metamorphopsia and foveal microstructure in patients withepiretinal membrane[J].Invest Ophthalmol Vis Sci,2012,53(11):6770-6775.doi:10.1167/iovs.12-9683.
[9]Inoue M,Arakawa A,Yamane S,et al.Long-term outcome ofpreoperative disrupted inner/outer segment junctions assessedusing spectral-domain optical coherence tomography in patientswith idiopathic epiretinal membrane[J].Ophthalmologica,2012,228(4):222-228.doi:10.1159/000341606.
[10]Yu J,Jiang CH,Xu GZ,et al.Characteristics of idiopathicepiretinal membrane by new Fourier-domain optical coherencetomography[J].Chin J Ocul Fundus Dis,2009,25(3):179-181.[俞笳,姜春晖,徐格致,等.特发性黄斑前膜的频域光相干断层扫描特征以及与视力的相互关系[J].中华眼底病杂志,2009,25(3):179-181].
[11]Azzolini C,Patelli F,Codenotti M,et al.Optical coherencetomography in idiopathic epiretinal macular membrane surgery[J].Eur J ophthalmol,1999,9(3):206-211.
[2]Mitehell P,Smith W,Chey T,et al.Prevalence and associations of epiretinal membranes.The Blue Mountain Eye Study Australia[J].Ophthalmology,1997,104(6):1033-1040.
[3]Miyazaki M,Nakamura H,Kubo M,et al.Prevalence and riskfactors for epiretinal membranes in a Japanese population:theHisayama study[J].Graefes Arch Clin Exp Ophthalmol,2003,241(8):642-646.
[4]Hikichi T,Trempe CL.Risk of bilateral idiopathic preretinalmacular fibrosis[J].Eye,1995,9(Pt1):64-66.
[5]Liu X,Ling YL,Zheng XP.Optical coherence tomography of idiopathicmacular epiretinal membranes[J].Chin J Ocul Fundus Dis,2001,17(2):115-118.[刘杏,凌运兰,郑小平.特发性黄斑视网膜前膜的光学相干断层扫描[J].中华眼底病杂志,2001,17(2):115-118].
[6]Wise GN.Clinical features of idiopathic preretinal macular fibrosis.Schoenberg Lecture[J].Am J Ophthalmol,1975,79(3):349-357.
[7]Hajnajeeb B,Georgopoulos M,Sayegh R,et al.The role of theoptical coherence tomography in identifying shape and size ofidiopathicepiretinal membranes[J].Br J Ophthalmol,2012,96(6):867-871.doi:10.1136/bjophthalmol-2011-300629.
[8]Okamoto F,Sugiura Y,Okamoto Y,et al.Associations between metamorphopsia and foveal microstructure in patients withepiretinal membrane[J].Invest Ophthalmol Vis Sci,2012,53(11):6770-6775.doi:10.1167/iovs.12-9683.
[9]Inoue M,Arakawa A,Yamane S,et al.Long-term outcome ofpreoperative disrupted inner/outer segment junctions assessedusing spectral-domain optical coherence tomography in patientswith idiopathic epiretinal membrane[J].Ophthalmologica,2012,228(4):222-228.doi:10.1159/000341606.
[10]Yu J,Jiang CH,Xu GZ,et al.Characteristics of idiopathicepiretinal membrane by new Fourier-domain optical coherencetomography[J].Chin J Ocul Fundus Dis,2009,25(3):179-181.[俞笳,姜春晖,徐格致,等.特发性黄斑前膜的频域光相干断层扫描特征以及与视力的相互关系[J].中华眼底病杂志,2009,25(3):179-181].
[11]Azzolini C,Patelli F,Codenotti M,et al.Optical coherencetomography in idiopathic epiretinal macular membrane surgery[J].Eur J ophthalmol,1999,9(3):206-211.