视网膜血流仪对环扎加压术前后眼底血流动力学的检测

目的应用共焦激光扫描多普勒视网膜血流仪检测孔源性视网膜脱离患眼环扎加压术前后眼底血流动力学的改变,并探讨其影响因素。方法应用Heidelberg共焦激光扫描多普勒视网膜血流仪分别测定47例视网膜脱离患者术前1 d及术后1周、1月和3月患眼与对侧眼的视网膜大血管的血容量、血流量和红细胞平均速率,以对侧眼为对照。结果术前及术后患眼与对侧眼视网膜大血管的血容量、血流量和红细胞平均速率的差异均具有统计学意义(P<0.01)。屈光是影响术前患眼视网膜颞上动脉各血流参数的主要因素,环扎缩紧率是影响术后1周患眼视网膜颞上动脉各血流参数改变的主要因素。术后各眼均未发生眼部缺血症状,视力恢复理想。结论视网膜脱离时即有患眼视网膜血供的下降,环扎加压术后血供进一步减少,并随时间有一定程度的恢复,血流动力学的改变在短期内对患眼的恢复无明显影响。共焦激光扫描多普勒视网膜血流仪为检测眼底血流变化较为理想的方法。

Detection of ocular fundus hemodynamics before and after scleral buckling by retina flowmeter

Objective To detect the ocular fundus hemodynamic changes in patients with rhegmatogenous retinal detachment before and after the scleral buckling procedure by Heidelberg retina flowmeter,and analyse the related influential factors. Methods Heidelberg retina flowmeter was employed to measure the volume,flow and velocity in retinal vessels of the impaired eyes in 47 patients with unilateral rhegmatogenous retinal detachments 1 day before and 1 week,1 month and 3 months after scleral buckling procedure.The contralateral eyes were served as controls. ResultsThere were significant differences in the volume,flow and velocity of retinal vessels between the impared eyes and controls preoperation and postoperation(P<0.01).The refractive factor was the main factor which affected the preoperative hemodynamic parameters.The degree of tightness of the encircling band was the main surgical factor which induced the hemodynamic changes 1 week postoperation.No ischemic syndrome was observed postoperation and expected visual improvement was achieved Conclusion The retinal blood flow decreases after retinal detachment.Scleral buckling procedure further decreases blood flow in retina for a short time after surgery,with no great harm to the anatomic and functional repair.Heidelberg retina flowmeter is a useful tool in the detection of retinal hemodynamic changes.