孔源性视网膜脱离患者术后对比敏感度

目的 了解视力恢复良好的孔源性视网膜脱离(RRD)术后对比敏感度情况,并进一步分析其与有无累及黄斑的相关性.方法 回顾性病例对照研究.选取50例(50眼)术后最佳矫正视力达到或超过4.9的单纯性RRD患眼,根据术前光学相干断层扫描检查结果分为黄斑脱离组(20眼)和黄斑未脱离组(30眼).另选30例(30眼)作为正常对照组.术后采用CSV- 1000E测定各组在眩光及无眩光状态下的对比敏感度.最佳矫正视力、各空间频率的对比敏感度值比较采用单因素方差分析,两两比较采用LSD t检验.结果 平均随访(12.2±5.3)个月,3组间最佳矫正视力差异无统计学意义(F=2.200,P＞0.05).在有眩光和无眩光状态下,黄斑脱离组和黄斑未脱离组在各个空间频率下都低于正常对照组,差异具有统计学意义(F=12.577～45.438,P均＜0.01).黄斑脱离组和黄斑未脱离组在有眩光18.0 c/d空间频率的对比敏感度分别为0.69±0.33、0.87±0.23,差异有统计学意义(t=2.418,P＜0.05),其余空间频率黄斑脱离组和黄斑未脱离组差异无统计学意义.结论 尽管部分RRD患者视力可以恢复良好,但对比敏感度仍不能恢复至正常人水平.与术前黄斑未脱离者相比,术前黄斑脱离的患者术后有眩光18.0 c/d状态下的对比敏感度较差.

Evaluation of contrast sensitivity for patients with rhegmatogenous retinal detachment

Objective To test the contrast sensitivity （CS） of patients with excellent visual acuity after rhegmatogenous retinal detachment （RRD） surgery, and to analyze whether retinal detachment involving or not involving the macula is correlated with contrast sensitivity. Methods It was a retrospective case-control study. A total of 50 RRD patients （50 eyes） whose postoperative best corrected visual acuity （BCVA） was 4.9 or better than 4.9 on a standard logarithmic visual acuity chart were enrolled. Patients were divided into a group with macular involvement （n=20） and a group without macular involvement （n=30） based on preoperative optical coherence tomography exams. Thirty normal eyes were enrolled as a normal control group. Contrast sensitivity with and without glare was tested with CSV-1000E. Single factor analysis of variance was used to compare BCVA and CS at each spatial frequency for the 3 groups. A LSD t test was used for further comparison of the 3 groups. Results The difference in BCVA for each of the 3 groups was not statistically significant （F=2.200, P〉0.05）. The CS values with and without glare were higher for the normal control group than for the groups with and without macular involvement （F=12.577-45.438, P values all〈0.01）. The CS values with glare at 18 c/d spatial frequency for the group without macular involvement was higher than that for the group with macular involvement （0.87±0.23 vs 0.69±0.33, t=2.418, P〈0.05）. However, there were no statistically significant differences at any other spatial frequency between the 2 groups. Conclusion Although some patients with RRD can have excellent visual acuity after surgery, contrast sensitivity may not be restored to normal levels. The CS values with glare at 18 c/d spatial frequency for the goup with macular involvement were lower than that for the group without macular involvement.