特发性黄斑裂孔患者术后黄斑区视网膜微结构修复与视功能恢复关系研究

目的 观察特发性黄斑裂孔(IMH)患者术后黄斑区视网膜各层微结构解剖修复过程与视功能恢复的关系.方法 回顾性研究.选取手术治疗的IMH患者40例40眼,根据患眼术后1周～1个月光学相干断层扫描(OCT)图像微结构连续变化的愈合特征分为3组,其中,A组:裂孔缺损组织及黄斑中心凹曲线完全或部分修复,且已修复部分为椭圆体带先...

Relationship between postoperative macular microstructure repair and visual function recovery in patients with idiopathic macular fissure

Objective　To observe the relationship between the anatomical repair process of the retinal layers of the macula and the recovery of visual function after idiopathic macular fissure (IMH) surgery.Methods　Retrospective study. Forty eyes of 40 patients with surgically treated IMH were divided into three groups according to the healing characteristics of the successive changes of microstructure on optical coherence tomography (OCT) images from 1 week to 1 month after surgery, group A was patients with complete or partial repair of the lacunar defect and macular notch curve, and healing of the ellipsoid band, group B was patients with complete or partial repair of the lacunar defect and macular notch curve, and healing of the repaired portion of the retinal layer other than the ellipsoid band, and group C was patients who had no repair of the lacunar defect and macular notch curve. The best-corrected visual acuity (BCVA), microfield sensitivity (MS), optical coherence tomography (OCT) and multifocal electroretinography (mfERG) were compared in the three groups.Results　The healing time of the macular fissure in 34 eyes of 40 eyes ranged from 1 to 10 (5.42±3.16) days, and the complete docking time of the ellipsoidal band ranged from 2 to 12 (5.57±3.69) days. One week after operation, group A had a higher full-thickness healing rate than group B (P=0.038). At 1 week after surgery, the BCVA in group A was better than that in groups B and C, and the difference was statistically significant (both P<0.05). At 1 month, 3 months, and 6 months after surgery, the BCVA of group A and group B were both higher than that of group C, and the difference was statistically significant (both P<0.05), but there were no statistically significant differences between group A and group B (P>0.05). At 1 month after surgery, there was no statistically significant difference in MS of group A and group B compared with that before surgery (both P＞0.05), but MS in group A was better than that in group B and group B was better than that in group C (both P＜0.05); at 3 and 6 months after surgery, MS in group A and group B improved compared with that in group C (both P＜0.05), but there was no statistically significant difference in MS between group A and group B (P＞0.05). However, there was no statistically significant difference in MS between group A and group B (all P>0.05). At 6 months after surgery, the amplitude density and latency of macular center 1, 2 ring N1 and P1 waves in group A and group B were significantly improved compared with those before surgery (all P<0.05), but the difference was not statistically significant between group C and before surgery (P>0.05); the difference between group A and group B and group C was statistically significant (all P<0.05), but the difference between group A and group B was not statistically significant (P>0.05).Conclusion　The retinal microstructure in the macula of the eyes with first healing of the ellipsoidal zone at the early stage after IMH had a higher rate of full-layer healing and better recovery of visual function.