外伤性黄斑全层裂孔的OCT观察

目的 观察外伤性黄斑伞层裂孔的光学相干断层成像特征及转归.方法 对15例(15只眼)黄斑全层裂孔患者采用OCT检查观察两周至2年,分析其图像特征.结果 15只眼OCT图像均表现为黄斑区全层视网膜神经上皮缺失;15只眼中11例未进行手术治疗,其中4例在2周至8个月(36.4%)自然愈合,视力平均提高3.3行.6例(54.5%)观察了6个月至2年未愈合,视力提高1～2行者5例,下降者1例.1例(9.1%)在受伤后1～7个月期间发展成为全层裂孔,视力无明显变化;15只眼中4例进行了手术治疗,术后2个月至1年OCT显示裂孔愈合,2例视力提高了3行,2例视力无明显改善.结论 外伤性黄斑全层裂孔是有可能自然愈合的,采用OCT保守观察是外伤性黄斑裂孔治疗的一种选择.

Observation of full-thickness traumatic macular hole with the optical coherence tomography

Objective To observe the optical coherence tomography(OCT)characteristics of patients with full-thickness traumatic macular hole (TMH)and its outcomes.Methods Fifteen patients who suffered from unilateral TMH were followed up for 2 weeks to2 years after the OCT examination,in order to analyze their OCT characteristics and the outcomes of the disease.Results All 15 eyes showed manifestations of full-thickness loss of retinal neural epithelium on OCT.Eleven eyes were without surgery,in which 4 eyes (36.4%)had spontaneous closure with average improvement of 3.3 rows in visual acuity; 6 (54.5%)holes in 6 eyes did not close,with visual acuity improvement of 1-2 rows in 5 eyes and decline in 1 eye.One eye (9.1%) developed to be full-thickness hole 1 to 7 months after trauma without obvious change of visual acuity.Four eyes had been under surgery of vitrectomy,the holes all closed as shown on OCT;in which 2 eyes showed visual acuity improvement of 2 rows or higher, but no obvious improvement in the other 2 eyes.Conclusion Full-thickness traumatic maenlar hole islikely to close up spontaneously.Observation for a period with OC may be a choice for TMH.