黑色素相關(guān)近紅外眼底自發(fā)熒光聯(lián)合OCT評估孔源性視網(wǎng)膜脫離鞏膜扣帶術(shù)后早期黃斑功能的改變
發(fā)布時(shí)間：2019-04-03 20:42
【摘要】：目的 伴黃斑脫離的孔源性視網(wǎng)膜脫離（RRD）行鞏膜扣帶術(shù)，觀察術(shù)后初期黃斑區(qū)的黑色素相關(guān)近紅外眼底自發(fā)熒光表現(xiàn)（NIA）和光學(xué)相干斷層掃描（OCT）表現(xiàn)，通過將NIA與OCT相結(jié)合，對RRD鞏膜扣帶術(shù)后早期黃斑的結(jié)構(gòu)進(jìn)行評估。 方法 前瞻性系列病例研究。將行鞏膜扣帶術(shù)的21例（21眼）伴黃斑脫離的孔源性視網(wǎng)膜脫離患者納入本研究，全部患眼均經(jīng)雙目間接檢眼鏡和（或）裂隙燈顯微鏡結(jié)合前置鏡進(jìn)行確診。所有患眼術(shù)后經(jīng)檢眼鏡檢查眼底視網(wǎng)膜均復(fù)位，每次隨訪時(shí)視網(wǎng)膜均在位。應(yīng)用共聚焦激光眼底血管造影儀HRA2(海德堡視網(wǎng)膜脈絡(luò)膜眼底造影系統(tǒng)),對所有患眼術(shù)后3個(gè)月行NIA檢查和OCT檢查。通過與同一圖像的背景灰度進(jìn)行對比分析后，將異常熒光按熒光等級分為強(qiáng)熒光、弱熒光、無熒光。我們對患眼術(shù)后3個(gè)月的NIA及OCT結(jié)果進(jìn)行評估。觀察檢查圖像的異常和手術(shù)后視力的恢復(fù)情況。對視力的變化進(jìn)行配對t檢驗(yàn)，NIA與術(shù)后BCVA的相關(guān)性采用雙向無序分類變量資料的關(guān)聯(lián)性進(jìn)行分析。 結(jié)果 黃斑NIA結(jié)果：16眼表現(xiàn)為弱熒光周圍圍繞著強(qiáng)熒光，5眼表現(xiàn)為不均勻的強(qiáng)熒光。黃斑OCT結(jié)果：20眼存在黃斑下液，，其中6眼中心凹區(qū)視網(wǎng)膜神經(jīng)感覺層變薄，14眼正常；1眼無黃斑下液，中心凹區(qū)視網(wǎng)膜神經(jīng)感覺層變厚；21眼IS/OS反射異常。視力恢復(fù)情況：術(shù)后3個(gè)月視力與術(shù)后1天比較，NIA表現(xiàn)為弱熒光周圍圍繞著強(qiáng)熒光者，視力差異有統(tǒng)計(jì)學(xué)意義（t=9.922,P0.05），表明術(shù)后3個(gè)月較術(shù)后1天視力提高；NIA表現(xiàn)為不均勻強(qiáng)熒光者，視力差異無統(tǒng)計(jì)學(xué)意義（t=2.409,P0.05），尚不能表明術(shù)后3個(gè)月視力較術(shù)后1天視力有提高。黃斑NIA表現(xiàn)與術(shù)后BCVA變化高度相關(guān)（C=0.5020，p0.05）。 結(jié)論 伴黃斑脫離的孔源性視網(wǎng)膜脫離行鞏膜扣帶術(shù)后早期，黃斑區(qū)的結(jié)構(gòu)與功能均尚未完全恢復(fù)，需要我們加以重視。
[Abstract]:Objective to observe the (NIA) and optical coherence tomography (OCT) findings of melanin-related near infrared fundus spontaneous fluorescence (NIA) and optical coherence tomography (OCT) in macular region of (RRD) with macular detachment after scleral buckling. The early macular structure of RRD after scleral cingulate surgery was evaluated by combining NIA with OCT. Methods A prospective series of case studies was carried out. Twenty-one cases (21 eyes) of rhegmatogenous retinal detachment with macular detachment who underwent scleral buckling were included in this study. All eyes were diagnosed by binocular indirect ophthalmoscope and / or slit lamp microscope combined with anterior lens. All eyes were reattached after ophthalmoscope, and the retina was in place at each follow-up. Using confocal laser fundus angiography instrument HRA2 (Heidelberg retinal choroidal fundus angiography system), all eyes were examined by NIA and OCT 3 months after operation. After comparing and analyzing the background gray scale of the same image, the abnormal fluorescence was classified into strong fluorescence, weak fluorescence and no fluorescence according to the fluorescence grade. We evaluated the results of NIA and OCT at 3 months after eye surgery. The abnormal images and the recovery of visual acuity after operation were observed. Paired t-test was performed for visual acuity changes. The correlation between NIA and postoperative BCVA was analyzed by using two-way disordered classification variable data. Results the results of macular NIA showed that 16 eyes showed strong fluorescence around weak fluorescence, and 5 eyes showed non-uniform strong fluorescence. The results of macular OCT showed that submacular fluid was present in 20 eyes, of which 6 eyes were thinned and 14 eyes were normal in the central concave area, 1 eyes had no submacular fluid, the retinal nerve sensory layer thickened in the central concave area, and 21 eyes had abnormal IS/OS reflex. Visual acuity recovery: 3 months after operation compared with postoperative 1 day, NIA showed weak fluorescence around the strong fluorescence, the visual acuity difference was statistically significant (t = 9.922, P0.05), indicating that the postoperative 3 months compared with the postoperative 1 day visual acuity improved; There was no significant difference in visual acuity between the two groups (t = 2.409, P0.05). There was no significant difference in visual acuity between the two groups (t = 2.409, P0.05). It could not be seen that the visual acuity at 3 months after operation was better than that at 1 day postoperatively. The macular NIA findings were highly correlated with the changes of BCVA after operation (C = 0.502, p 0.05). Conclusion in the early stage of scleral cingulate surgery for rhegmatogenous retinal detachment with macular detachment, the structure and function of macular region have not been completely recovered, so we should pay more attention to it.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R774.1
本文編號：2453561
[Abstract]:Objective to observe the (NIA) and optical coherence tomography (OCT) findings of melanin-related near infrared fundus spontaneous fluorescence (NIA) and optical coherence tomography (OCT) in macular region of (RRD) with macular detachment after scleral buckling. The early macular structure of RRD after scleral cingulate surgery was evaluated by combining NIA with OCT. Methods A prospective series of case studies was carried out. Twenty-one cases (21 eyes) of rhegmatogenous retinal detachment with macular detachment who underwent scleral buckling were included in this study. All eyes were diagnosed by binocular indirect ophthalmoscope and / or slit lamp microscope combined with anterior lens. All eyes were reattached after ophthalmoscope, and the retina was in place at each follow-up. Using confocal laser fundus angiography instrument HRA2 (Heidelberg retinal choroidal fundus angiography system), all eyes were examined by NIA and OCT 3 months after operation. After comparing and analyzing the background gray scale of the same image, the abnormal fluorescence was classified into strong fluorescence, weak fluorescence and no fluorescence according to the fluorescence grade. We evaluated the results of NIA and OCT at 3 months after eye surgery. The abnormal images and the recovery of visual acuity after operation were observed. Paired t-test was performed for visual acuity changes. The correlation between NIA and postoperative BCVA was analyzed by using two-way disordered classification variable data. Results the results of macular NIA showed that 16 eyes showed strong fluorescence around weak fluorescence, and 5 eyes showed non-uniform strong fluorescence. The results of macular OCT showed that submacular fluid was present in 20 eyes, of which 6 eyes were thinned and 14 eyes were normal in the central concave area, 1 eyes had no submacular fluid, the retinal nerve sensory layer thickened in the central concave area, and 21 eyes had abnormal IS/OS reflex. Visual acuity recovery: 3 months after operation compared with postoperative 1 day, NIA showed weak fluorescence around the strong fluorescence, the visual acuity difference was statistically significant (t = 9.922, P0.05), indicating that the postoperative 3 months compared with the postoperative 1 day visual acuity improved; There was no significant difference in visual acuity between the two groups (t = 2.409, P0.05). There was no significant difference in visual acuity between the two groups (t = 2.409, P0.05). It could not be seen that the visual acuity at 3 months after operation was better than that at 1 day postoperatively. The macular NIA findings were highly correlated with the changes of BCVA after operation (C = 0.502, p 0.05). Conclusion in the early stage of scleral cingulate surgery for rhegmatogenous retinal detachment with macular detachment, the structure and function of macular region have not been completely recovered, so we should pay more attention to it.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R774.1
【參考文獻(xiàn)】
相關(guān)期刊論文 前3條
1 陳輝;眼底自發(fā)熒光技術(shù)在眼科中的應(yīng)用[J];國際眼科雜志;2004年03期
2 孫怡雯;屈軍樂;趙羚伶;許改霞;丁志華;牛憨笨;;眼底視網(wǎng)膜色素上皮層細(xì)胞脂褐素及氧化黑色素自體熒光壽命成像研究[J];物理學(xué)報(bào);2008年02期
3 ;Lipofuscin-and Melanin-related Fundus Autofluorescence in Patients with Submacular Idiopathic Choroidal Neovascularization[J];Eye Science;2012年03期
本文編號：2453561
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