原发性玻璃体后脱离致视网膜裂孔的治疗探讨

目的 分析玻璃体后脱离所致视网膜裂孔的确诊时间及不同处理对其预后的影响。方法 2000年10月至2002年8月对95例(95眼)由急性玻璃体后脱离所致视网膜裂孔眼进行临床分析。裂孔已导致视网膜脱离的行视网膜复位手术，干性视网膜裂孔行532激光封闭裂孔术。结果 59例伴有视网膜脱离的患者明确诊断时间长，经手术治疗(部分为玻璃体手术)后视功能有一定的恢复，但有些病人需多次手术。35例视网膜干性裂孔患者诊断及时，经光凝治疗后视力无明显改变。结论 玻璃体后脱离导致视网膜裂孔早期诊断，及时光凝是为患眼争取良好预后的关键。     

OCT与眼科B超联合在玻璃体后脱离检测中的应用

目的 探讨光学相干断层扫描(OCT)联合眼科B超在检测玻璃体后脱离(PVD)中的应用价值.方法 将305例(607只眼)青壮年近视患者利用OCT、眼部B超进行PVD检测,利用SPSS17.0统计软件计算两种方法单独和联合应用检出率,并对两种方法检出的差异性和一致性进行分析.结果 OCT检测PVD阳性共155只眼,检出率为25.54%,B超检测PVD阳性共83只眼,检出率为13.67%,两种方法联合共检测PVD阳性161只眼,检出率为26.52%.差异性分析中OCT法PVD检出率高于B超法,差异有统计学意义(X2=_61.714,P＜0.05).一致性分析中Kappa值为0.571,并进行U检验(u=15.077,P-0.000),显示Kappa值受机遇影响较小.结论 OCT法对青壮年近视患者PVD的检出率明显优于眼科B超,两种方法联合应用可进一步提高PVD的检出率.

Abstract：

Objective To evaluate the value of optical coherence tomography combined with B-scan testing in posterior vitreous detachment. Methods A total of 305 young adult cases (607 eyes)with myopia were examined for posterior vitreous detachment by optical coherence tomography and B-scan. The detection rates by single and combined method were accounted by SPSS 17.0 statistical analysis software, and the difference and the consistency between two methods were analyzed. Results Of 155 eyes were detected by OCT, and 83 eyes were detected by B-scan, whereas 161 eyes were detected by combined methods, the detection rate was 25.54%, 13.67%, 26.52%, respectively.The detection rate by OCT was higher than that by B-scan, and the difference between two methods had statistical significance in variability analysis (X2=61.714, P＜0.05). The Kappa value was 0.571 in consistency analysis, and the consequence of u test manifested that the kappa value had been seldom influenced by chance element (u =15.077, P =0.000). Conclusions OCT has more apparent advantage than B-scan in detecting PVD in young adult myopia. The two methods combined together can further rise up the detection rate of PVD.