特发性黄斑裂孔手术前后矫正视力及多焦视网膜电图比较

目的 观察特发性黄斑裂孔(IMH)玻璃体切割手术(PPV)联合吲哚青绿(ICG)辅助内界膜剥除治疗前后的矫正视力及多焦视网膜电图(mfERG)的改变.方法 回顾分析我科接受PPV联合0.25%ICG辅助内界膜剥除治疗的特发性黄斑裂孔患者19例19只眼的临床资料.所有患眼手术前裂孔情况和手术后2个月裂孔闭合情况均以OCT检查为依据.采用VERIS Science 4.9视觉诱发反应图像系统观察手术前及手术后2、6、12个月患者mfERG6个环形视网膜区域mfERG的P1波振幅密度,同时分析比较手术前后最佳矫正视力的改变情况.结果 手术后2个月,OCT检查显示16例16只眼黄斑裂孔闭合,占84.21%;3例3只眼黄斑裂孔未闭合,占15.79%.手术后最佳矫正视力较手术前提高,其中以手术后2个月提高幅度最大(F=6.389,P=0.045).手术后2、6、12个月mfERG各环P1波振幅较手术前均明显降低,其差异均有统计学意义(t=6.140,P＜0.05).结论 IMH患者手术后最佳矫正视力提高;手术后P1波振幅较手术前降低.

Comparisons of visual acuity and multifocal electroretinogram before and after successful idiopathic macular hole surgery

Objective To observe the changes of visual acuity and multifocal electroretinogram (mfERG)before and after pars plana vitrectomy (PPV) combined with internal limiting membrane(ILM)peeling with ICG on idiopathic macular hole surgery.Methods The clinical data of 19 patients (19 eyes)with idiopathic macular hole(IMH) who had undergone PPV combined with ILM peeling assisted by 0.25 %ICG from Zhongshan Ophthalmic Center were retrospectively analyzed.The closure of macular holes was confirmed by OCT two months after surgery.VERIS Science 4.9 visual evoked response image system was used to record the amplitude density of P1 waves according to six concentric rings before and two,six,twelve months after surgery,meanwhile compared and analyzed best corrected visual acuity(BCVA)before and after surgery.Results The results of OCT showed that 16 eyes (84.21%) had anatomic closure of the macular hole two months after the surgery while three eyes (15.79%) failed in the closure.The BCVA after surgery improved significantly which was more obvious at the second month (F=6.389,P＜0.05).Compared with before surgery,the responses were depressed severely in P1 wave amplitude densities in six rings,the differences were statistically significant (t=6.140,P＜0.05).Conclusion The postoperative BCVA of IMH patients improved but the amplitude densities of P1 wave depressed compared with before surgery.