摘要
目的 探讨特发性黄斑裂孔玻璃体切割手术后影响裂孔解剖愈合的相关因素.方法 回顾性临床研究.行玻璃体切割联合内界膜剥除手术的特发性黄斑裂孔患者164例165只眼纳入研究.其中,男性43例,女性121例;平均年龄（64.0±6.7）岁.采用最小分辨角对数（logMAR）视力表行矫正视力检查,以及间接检眼镜、频域光相干断层扫描（SD-OCT）检查.患眼平均logMAR矫正视力1.0;平均病程（8.7±14.9）个月;平均裂孔最小径（MIN）、裂孔底径（BASE）、裂孔高度（H）分别为521、1010、406 μm;平均黄斑裂孔指数（MHI）、裂孔牵拉指数（THI）、孔径指数（DHI）、黄斑裂孔愈合指数（MHCI）分别为0.43、0.82、0.57、0.92.根据患眼手术后SD-OCT图像特征,将黄斑裂孔愈合分为A、B、C级.A级：黄斑裂孔桥状愈合;B级：黄斑裂孔良好愈合;C级：黄斑裂孔不良愈合.手术后平均随访时间（3.6±3.2）个月.观察黄斑裂孔愈合形态,并与患者年龄、性别、手术前病程、logMAR矫正视力、黄斑裂孔各测量参数、指数行相关性分析.结果 165只眼中,黄斑裂孔愈合A、B、C级分别为30、120、15只眼.相关性分析结果显示,黄斑裂孔愈合等级与病程（r=0.141）、手术前logMAR矫正视力（r=0.082）、年龄（r=0.044）、性别（r=0.109）无关;与MIN（r=0.397）、BASE（r=0.276）、H（r=-0.240）、MHI（r=-0.363）、THI（r=-0.432）、DHI（r=0.272）呈弱相关或低度相关（P＜0.05）.MHCI与手术后黄斑裂孔愈合等级呈显著相关（r=-0.543,P=0.000）.A、B、C级MHCI中位数分别为1.07、0.91、0.56.A、B、C级MHCI比较,差异有统计学意义（H=52.857,P＜0.05）.结论 MHCI与裂孔愈合等级的相关性最好,可视为影响手术后裂孔愈合的主要因素并作为预测解剖愈合的指标.
Objective To evaluate the associated factors for predicting anatomical outcomes of idiopathic macular hole （IMH） after vitrectomy.Methods This is a retrospective study.A total of 165 eyes in 164 IMH patients underwent a successful vitrectomy and ILM peeling surgery were included in this study.The patients included 43 males and 121 females,with the mean age of （64.0±6.7） years.The corrected vision acuity of logarithm of the minimum angle of resolution （logMAR）,indirect ophthalmoscope and spectral domain optical coherence tomography （SD-OCT） were measured for all patients.The mean logMAR corrected vision acuity was 1.0.The duration of disease was （8.7±14.9） months.The minimum diameter （MIN）,base diameter （BASE） and height （H） were 521,1010,406 μm respectively.The macular hole index （MHI）,tractional hole index （THI）,diameter hole index （DHI） and macular hole closure index （MHCI） were 0.43,0.82,0.57,0.92 respectively.Anatomical outcomes were divided into 3 levels.A：bridge-shaped healing; B：good healing; C：poor healing.The mean follow-up was （3.6±3.2） months.The multiple factors related with prognosis including age,sex,duration of disease,preoperative logMAR corrected vision acuity,MIN,BASE and H,MHI,THI,DHI,MHCI were analyzed.Results Duration of disease （r=0.141）,preoperative logMAR corrected vision acuity （r=0.082）,age （r=0.044）,sex （r=0.109） was independent of anatomical prognosis （P＞0.05）.MIN （r=0.397）,BASE （r=0.276）,H （r=-0.240）,MHI （r=-0.363）,THI （r=-0.432）,DHI （r=0.272） was weak correlation to anatomical prognosis （P＜0.05）.MHCI correlated significantly with anatomical outcomes （r=-0.543,P=0.000）.The median MHCI of A,B and C were 1.07,0.91,0.56 respectively.There were significant difference of MHCI among the three levels （H =52.857,P＜0.05）.Conclusions MHCI has the best correlation with anatomical outcomes.It can be considered a key factor for predicting anatomical outcomes of IMH after vitr
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2014年第4期339-342,共4页
Chinese Journal of Ocular Fundus Diseases
关键词
视网膜穿孔
外科学
体层摄影术
光学相干
预后
Retinal perforations/surgery
Tomography, optical coherence
Prognosis
