孔源性视网膜脱离眼黄斑区光相干断层扫描 特征与视力预后的关系

目的观察孔源性视网膜脱离患者黄斑区组织形态学改变与手术后视力预后的关系。方法对39例孔源性视网膜脱离患者39只眼进行光相干层扫描（OCT）检查，根据OCT显示的黄斑区神经上皮层形态，分为神经上皮水肿（水肿组）、神经上皮层间分离（分离组）、神经上皮囊样变性（囊样变组）3组，对3组之间视网膜脱离时间、手术前后视力以及OCT检测的黄斑区神经上皮层厚度进行相关指数的秩和及多重比较检验。结果3组患者手术前视力比较，其差异均无统计学意义(P＞0.05)；手术后视力、视网膜脱离时间及神经上皮层厚度三方面的差异均有统计学意义(P＜0.05)。分离组与囊样变组患者在视网膜脱离时间及神经上皮层厚度方面比较，其差异有统计学意义(P＜0.05)，而手术后视力差异无统计学意义(P＞0.05)。结论视网膜脱离患者的视网膜脱离时间、手术后视力均与OCT检测的神经上皮层厚度有相关关系。视网膜脱离时间越长，脱离的黄斑区视网膜神经上皮层厚度增加，视网膜组织形态学改变越明显，手术后视力愈差。(中华眼底病杂志,2005,21:83-85)

Relationship between the macular histomorphological changes and the prognosis of the visual acuity in eyes with retinal detachment

Objective To invesitigate the relationship between the macular histomorphological changes and the prognosis of the visual acuity (VA) in eyes with rhegmatogenous retinal detachment (RRD). Methods Optical coherence tomography (OCT) was performed on 39 patients (39 eyes) with rhegmatogenous retinal detachment. According to the macular neurepithelial configuration displayed by OCT, the patients were divided into 3 groups: neurepithelial edema group, neurepithelial detachment group, and neurepithelial cystoid degeneration group. The time of retinal detachment, pre- and post-operative VA, and macular neurepithelial thickness OCT images were observed and analyzed statistically. Results There was no difference of pre-operative VA among the three groups (P>0.05). Significant differences of post-operative VA, time of retinal detachment, and neurepithelial thickness were found (P<0.05). The differences of time of retinal detachment and neurepithelial thickness between neurepithelial degeneration group and cystoid degeneration group were significant (P<0.05) except the post-operative VA (P>0.05). Conclusions The time of retinal detachment and post-operative VA in patients with retinal detachment relate to the neurepithelial thickness detected by OCT. When the duration of retinal detachment becomes longer, the macular neurepithelium becomes thicker, the histomorphological changes increase, and the post-operative VA decreases.