孔源性视网膜脱离全视野视网膜光敏感度的研究

The Study Of The Retinal Light Sensitivity on the Patients with Rhegmatogenous Retinal Detachment

目的：通过定量检测全视野视网膜光敏感度（ＲＬＳ），进一步判断裂孔源性视网膜脱离的视网膜功能及治疗前后的变化。方法：采用Ｈｕｍｐｈｅｒｙ自动视野分析仪，在任意程序下设计全视野７５℃范围内８８点的阈值程序，测定全视野视网膜光敏感度，其中正常对照组５０眼，裂孔源性视网膜脱离眼及健眼各３０眼。结果：正常人ＲＬＳ为（１７．５８±３．７８）ｄＢ，上方视野较下方视野，周边视野较中心视野ＲＬＳ低；视网膜脱离患者健眼ＲＬＳ明显低于正常对照组，视网膜脱离眼ＲＬＳ明显低于健眼，其中未脱离部位ＲＬＳ也低于健眼，以上差异均非常显著（Ｐ＜０．０１）；视网膜脱离解剖复位后ＲＬＳ可获明显提高，尤其在病程＜１月或单孔网脱时，治疗前后ＲＬＳ差异非常显著（Ｐ＜０．０１）。结论：视网膜脱离患者双眼视网膜感光功能均有不同程度明显下降。视网膜在脱离状态时，视网膜功能损害不仅可以累及脱离部位视网膜，也可累及未脱离部位视网膜。视网膜脱离的时间和视网膜变性性改变的程度是影响视网膜解剖复位后功能恢复的主要原因，提示早期诊断和早期治疗对提高视网膜脱离患者视网膜解剖复位后的功能恢复是十分重要的。

Objective:To study the retinal function and its change between the preoperation and postoperation for the patients with rhegmatogenous retinal detachment (RRD). Methods:Under the threshold program of 88 points within 75℃, we used Humphrey Field Analyzer to meassure the retinal light sensitivity (RLS) for 50 eyes of the normal persons 30 eyes of RRD and 30 opposite eyes of RRD. Results: The RLS for the normal eyes was 17.58±3.78 dB and the RLS in the upper and peripheral visual field was respectively lower than that in the inferior and central visual field; The RLS for opposite eyes with RRD was significantly lower than that for the normal eyes and the RLS for the detached area of RRD eyes was also significantly lower than that for undetached retina of RRD eyes. The RLS could increase obviously after retinal reduction, especially for those RRD eyes with the course lower than one month or with single hole. Conclusion: The RLS of bilateral eyes for the patients with RRD significantly decreased in different degree and the lesion of retinal function includes not only the detached retina but the undetached retina. The time of RRD and the degree of retinal degeneration were the main cause impeding the recovery of the retinal function after reduction.