本文選題：體層攝影術　切入點：光學相干　出處：《廣西醫(yī)科大學》2013年碩士論文　論文類型：學位論文

【摘要】：目的分析單眼中心性漿液性脈絡膜視網膜病變中,發(fā)病眼與對側健康眼黃斑區(qū)神經上皮層的形態(tài)學差異,及其臨床意義。 方法研究對象為單眼發(fā)病,對側眼無病變的中心性漿液性脈絡膜視網膜病變患者,共67例入組。對比發(fā)病眼與對側眼最佳矯正視力,屈光狀態(tài),中心凹神經上皮厚度間的差異。按照雙眼間中心凹厚度的差值將病例分成2組：非變薄組發(fā)病眼的中心凹厚于或等于對側眼；變薄組發(fā)病眼的中心凹薄于對側眼。分析2組間年齡,病程,視力,雙眼視力差值,中心凹處網膜總高度,中心凹厚度,網膜下液高度等參數(shù)是否存在差異。此外,分別在全體病例,非變薄組與變薄組內進行針對視力,中心凹厚度與其他指標之間的雙變量相關性分析。 結果發(fā)病眼的矯正視力為0.6(0.4-0.8),對側眼的矯正視力為1.0(1.0-1.2),2組間差異有統(tǒng)計學意義(Z=-6.507,P0.01)。發(fā)病眼中心凹神經上皮層厚度為161.80±29.33um,對側眼中心凹神經上皮層厚度為175.06±16.29um,2組間差異有統(tǒng)計學意義(t=-3.982,P0.01)。全體病例中,發(fā)病眼最佳矯正視力與視網膜總高度(r=-0.289,P0.05),視網膜下液高度(r=-0.361,P0.01),中心凹神經上皮層厚度(r=0.385,P0.01)的相關性具有統(tǒng)計學意義。發(fā)病眼中心凹神經上皮層厚度與病程(r==-0.286,P0.05),與最佳矯正視力的相關性具有統(tǒng)計學意義。分組以后分析顯示,非變薄組的最佳矯正視力為0.80(0.50-0.95),變薄組的最佳矯正視力為0.50(0.30-0.60),2組間差異有統(tǒng)計學意義(Z=-3.161,P0.01)。非變薄組的病程為12天(7-30天),變薄組的病程為30天(14-60天),2組差異有統(tǒng)計學意義(Z=-2.683,P0.01)。在非變薄組內,最佳矯正視力與年齡(r=-0.407,P0.05),視網膜下液高度(r==-0.396,P0.05)的相關性有統(tǒng)計學意義,中心凹神經上皮層厚度與年齡(r=0.448,P0.05)的相關性有統(tǒng)計學意義。在變薄組內,最佳矯正視力,中心凹神經上皮層厚度與其它指標間的相關性分析結果均沒有統(tǒng)計學意義。 結論在單眼中心性漿液性脈絡膜視網膜病變中,發(fā)病眼與對側健康眼的中心凹厚度存在差異性。這種差異性包含了患者的病程與視功能方面的信息。當發(fā)病眼中心凹厚度薄于對側眼時,提示相對更長的病程,更嚴重的視力損害。
[Abstract]:Objective to analyze the morphologic differences and clinical significance of neuroepithelium in monocular central serous chorioretinopathy between the affected eyes and the contralateral healthy eyes. Methods Sixty-seven patients with central serous chorioretinopathy without contralateral eye involvement were enrolled in the study. The best corrected visual acuity and refractive state were compared between the affected eyes and the contralateral eyes. According to the difference of the thickness of the central fovea between the eyes, the patients were divided into two groups: the fovea of the non-thinning group was thicker than or equal to that of the contralateral eye; Age, course of disease, visual acuity, binocular visual acuity difference, total height of omentum at fovea, thickness of fovea, height of subomentum fluid were analyzed in the thinning group. The correlation between vision, fovea thickness and other parameters was analyzed in all cases, non-thinning group and thinning group. Results the corrected visual acuity of the affected eyes was 0.6 ~ 0.4-0.80.The corrected visual acuity of the contralateral eye was 1.0 ~ 1.0-1.2 / 2. There was significant difference between the two groups. The thickness of the central foveal epithelium layer was 161.80 鹵29.33 um. the thickness of the contralateral central foveal neuroepithelial layer was 175.06 鹵16.29 um2. In all cases, The correlation between the best corrected visual acuity (BCVA) and the total retinal height (r-0.289), the subretinal fluid height (r-0.361) and the thickness of central foveal neuroepithelial layer (RNEC) were statistically significant. The thickness of neuroepithelial layer in the central fovea and the course of disease were significantly correlated with the best correction. The correlation of visual acuity was statistically significant. The best corrected visual acuity (BCVA) of the non-thinning group was 0.80,0.50-0.95g, and the best corrected visual acuity of thinning group was 0.50,0.30-0.600.The difference between the two groups was statistically significant. The course of disease in non-thinning group was 12 days, 7-30 days, and the course of disease in thinning group was 30 days 14-60 days. In the non-thinning group, The correlation between the best corrected visual acuity (BCVA) and the age (r) -0.407 (P0.05), the height of the subretinal fluid (RV) -0.396 (P0.05) was statistically significant, and the correlation between the thickness of the neuroepithelium layer of the fovea and the age (P _ (0.05)) was statistically significant. In the thinning group, the best corrected visual acuity was the best. There was no significant correlation between the thickness of the neuroepithelial layer of the fovea and other indexes. Conclusion in monocular central serous chorioretinopathy, There is a difference in the foveal thickness between the affected eye and the contralateral healthy eye. This difference contains information about the course of the disease and visual function. When the foveal thickness of the affected eye is thinner than that of the contralateral eye, it indicates a longer course of disease. More severe visual impairment.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R773.4

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本文編號：1643819