视网膜脱离术后黄斑形态学异常与视功能的关系

Research on macular morphological abnormities and visual function after retinal reattachment

为研究视网膜脱离术后黄斑形态学改变与视功能间的关系 ,分析在我院采用环扎加压手术并得到随访的孔源性视网膜脱离患者 12 4例 (12 8眼 )的黄斑形态学改变并结合术后视力进行分析。结果 :术前只有 5 3.9%患者视力≥ 0 .0 5 ,术后提高到 91.4% ,两者相比差异有非常显著性 (P<0 .0 1)。术后黄斑色素紊乱发生率为 2 7.3% ,黄斑表面膜发生率为 10 .9% ,黄斑水肿发生率为 4.7% ,黄斑皱襞发生率为 1.6 % ;在高视力组 (≥ 0 .3)中 2 9.7%有黄斑明显异常 ,在低视力组 (<0 .0 5 )黄斑各种异常发生率升高至90 .9% ,两者差异有非常显著性 (P<0 .0 1)。研究表面膜发生原因中发现 92 .2 %患者具有上方象限的裂孔 ,而且其中 5 7.1%为 2个 PD以上的大裂孔。结论 :视网膜脱离术后视力得到部分恢复 ,低视力与术后黄斑色素紊乱、黄斑表面膜、黄斑水肿等黄斑部异常改变有关 。

Objective:To study the relationship between morphological abnormities and visual acuity after retinal reattachment.Methods:Study 124 patients(128eyes)with rhegmatogenous retinal detachment through scleral buckling surgery.Observe macular abnormities and visual acuity after retinal reattachment.Results:The visual acuity of 91 4% eyes was better than 0 05 after surgery and only 53 9% eyes had the same visual acuity before surgery(P<0 01).In all eyes,the occur rate of macular pigment disorder was 27 3%,macular epiretinal membranes was 10 9%,macular edema was 4 7%,macular pucker was 1 6%.In the high visual group(VA≥0 3),the occur rate of macular disorder was 29 7%.Otherwise,in the low visual group(VA<0 05),the occur rate of macular disorder was 90 9%(P<0 01).It was also found 92 2% eyes with macular epimembrane had superior quadrant holes and the size of 57 1% holes was bigger than 2PD.Conclusion:The visual acuity was partly improved after surgery.The low visual acuity was related with macular pigment disorder,maucular epiretinal membranes,macular edema,macular pucker and some other macular abnormities.The occur of macular epimembrane concerned with superior quadrant big holes.