摘要
目的观察Nd∶YAG激光内界膜(internal limiting membrane,ILM)切开术治疗视网膜ILM下出血的临床疗效。方法回顾性分析2021年8月至2022年12月,视网膜ILM下出血患者13例13只眼的临床资料,均采用Nd∶YAG激光切开术治疗。术后1周、1个月、3个月、6个月复查,观察最佳矫正视力(best corrected distance visual acuity,BCVA)改变,前置镜下眼底检查,广角眼底照相评估玻璃体腔积血吸收情况,采用光学相干断层扫描(optical coherence tomography,OCT)观察ILM下出血消退和激光孔闭合情况。同时,记录术中和术后并发症发生情况。结果13例患者治疗后BCVA与治疗前比较,差异具有统计学意义(P<0.05)。治疗后6个月,1例患者下方积血完全吸收,其余12例患者见玻璃体腔下方陈旧性积血。OCT结果显示:11例激光孔未闭,2例激光孔闭合;3例ILM贴于视网膜,10例患者ILM下空腔。所有患者黄斑区ILM下出血均引流成功,术中未损伤晶状体及角膜,术后也未见黄斑裂孔、黄斑前膜、视网膜裂孔、视网膜出血、视网膜脱离、脉络膜脱离严重等并发症。结论Nd∶YAG激光ILM切开术治疗视网膜ILM下出血安全、有效,无并发症。
Objective To observe the efficacy of Nd:YAG laser membranotomy treatment for sub-internal limiting membrane hemorrhage.Methods A retrospective study was made on 13 patients(13 eyes)diagnosed with sub-internal limiting membrane hemorrhage over the period from Aug.2021 to Dec.2022.All the patients were given Nd:YAG laser membranotomy.Their best corrected visual acuity(BCVA)was observed and fundus examination,wide-angle fundus imaging and OCT were performed 1 week,1 month,3 months and 6 months after the treatment respectively.The postoperative BCVA change,results of wide-angle fundus photography and OCT,absorption of internal sub-limiting membrane hemorrhage and complications incurred were observed.ResultsAAmong the 13 patients(13 eyes),11(11 eyes)were diagnosed with Valsalva retinopathy and 2(2 eyes)with retinal aneurysm.The onset time was 0.5-15 days(6.3±4.9 days on average),and the BCVA(logMAR)was 0.51±0.28,0.29±0.20,0.14+0.22 and 0.15±0.22 respectively 1 week,1 month,3 months and 6 months after the treatment.One week after the treatment,the ILM hemorrhages in all the affected eyes were fully absorbed,and the vision of the patients was improved.Six months after the treatment,1 patient had a complete absorption of vitreous hemorrhage,which was observed with wide-angle fundus photography,and the remaining 12 patients had old vitreous hemorrhage below the vitreous cavity.The results of OCT showed there were opened laser holes in ll patients,closed laser holes in 2 patients,sub-internal membrane attached to retina in 3 patients and subinternal membrane cavity in the remaining 10 patients.Conclusions Bringing in no complication for internal limiting membrane hemorrhage,Nd:YAG laser membranotomy is safe and effectivewithgoodvision.
作者
周芬
蒋沁
姚进
ZHOU Fen;JIANG Qin;YAO Jin(Affiliated Eye Hospital of Nanjing Medical University,Nanjing 290091,China)
出处
《中国激光医学杂志》
CAS
2024年第2期72-75,119,120,共6页
Chinese Journal of Laser Medicine & Surgery
基金
国家自然科学基金面上项目(82271101)。
关键词
激光
视网膜内界膜下出血
超广角眼底照相
OCT
Laser
Sub-internal limiting membrane hemorrhage
Ultra-wide-angle fundus photography
OCT
