球内异物伤玻璃体切割术后黄斑形态改变与视力的相关性研究

Relationship between the macular architecture and visual outcome after IOFB injuries managed by vitrectomy

目的从黄斑形态改变方面探讨球内异物伤玻璃体切割术后低视力的可能原因。方法观察行玻璃体切割手术的20只眼球内异物伤病例，术后3月行验光和黄斑OCT检查，测量黄斑中央小凹神经上皮层厚度（MNT），分析MNT及黄斑形态改变与预后视力的相关性。结果球内异物伤玻璃体切割术后3月，黄斑前膜的发生率为50％，黄斑前膜组和正常形态组之间视力存在显著性差异；MNT值与视力之间存在相关性：MNT值越大，视力越差。结论球内异物伤玻璃体切割术后黄斑形态异常以黄斑前膜的发生率最高，对视力有严重影响；黄斑中央小凹神经上皮层厚度越大，视力越差。

Objective To investigate the reason of poor visual outcome after IOFB injuries managed by vitrectomy through macular architecture by OCT. Methods Twenty eyes with posterior segment IOFB injuries by vitrectomy were prospectively investigated, by clinical examinations, optometry and OCT on the 3rd month postoperatively. The macular neurosensory retinal thickness （MNT） was measured and foveal architecture was observed through OCT. This study analyzed the relationship between MNT, foveal architecture and visual outcome. Results At the 3rd mouth postoperatively, 50% OCT showed macular epiretinal membranes, and there was statistical different visual acuity compared with normal foveal architectures （VA）. There was statistical correlation between VA and MNT. Conclusions The abnormal foveal architectures influence visual outcome, especially the macular epiretinal membranes. The thicker MNT is the poorer visual outcome.