23G玻璃体视网膜手术后视网膜血管直径与神经纤维层厚度及视盘的变化(英文)

Surgically induced changes in retinal vessel diameter,retinal nerve fiber layer thickness,and the optic disc after 23-gauge vitreoretinal surgical procedures

目的:调查接受睫状体平坦部玻璃体切割术及术中辅助治疗患者的视网膜血管直径,视网膜神经纤维层厚度和视盘改变。方法:共40例(40眼)接受单侧睫状体平坦部玻璃体切割术及术中辅助治疗患者纳入研究,分别于术前、术后3mo及6mo行视网膜照相检测视网膜中央动脉和静脉的直径,应用修正Parr-Hubbard公式计算视网膜中央动脉当量和视网膜中央静脉当量。运用Stratus OCT检测视神经纤维层厚度。立体视盘摄影检测视盘的垂直杯盘比。结果:术前患者的双眼视网膜血管直径与神经纤维层厚度及视盘检查无统计学差异。垂直杯盘比在3mo和6mo较术前明显增加(P<0.01,P<0.01),且手术眼与对侧眼显著不同(P<0.01,P<0.01)。术后6mo术眼视网膜中央动脉当量与视网膜中央静脉当量的改变明显大于对侧眼(P<0.01,P<0.01)。视神经纤维层厚度无显著变化。结论:玻璃体切割术及术中辅助治疗在术后6mo会引起视盘的垂直杯盘比及视网膜血管直径的改变,而视网膜神经纤维层厚度变化不明显。

AIM ： To investigate the retinal vascular caliber,retinal nerve fiber layer（ RNFL） thickness,and optic disc changes in patients after pars plana vitrectomy and adjunctive intraoperative procedures.METHODS： We examined 40 eyes in 40 patients who had undergone unilateral pars plana vitrectomy and adjunctive intraoperative procedure at three time points： prior to surgery,and at 3mo and 6mo after the operation. The diameters of central retinal arteries and veins were measured using retinal photographs. The central retinal arteriolar equivalent（ CRAE） and central retinal venular equivalent（ CRVE） were calculated using the revised Parr-Hubbard formula. RNFL thickness was obtained using Stratus optical coherence tomography. The cup- to- disc vertical ratio of the optic disc was evaluated using stereo optic disc photography.RESULTS： There were no significant differences between the eyes of individual patients before the operation. Cup- to- disc vertical ratios of the optic disc were significantly increased 3mo and 6mo postoperatively（ P〈0. 01,P〈0. 01）,and there was a significant difference between the operative eye and felloweye at the same time points（ P〈0. 01,P〈0. 01）. Changes in CRAE and CRVE in the operative eyes were significantly larger than the felloweyes 6mo post- operatively（ P〈0. 01,P〈0.01）. The RNFL thickness showed no significant changes.CONCLUSION： Whereas there were no changes in RNFL thickness, vitrectomy and adjunctive intraoperative procedures induced changes in the cup- to- disc vertical ratio of the optic disc and retinal vessel diameter for at least 6mo after surgery.