光相干断层成像在特发性黄斑前膜患者视功能评估中的应用

Application of optic coherent tomography in assessing visual performance of idiopathic macular epiretinal membrane patients

目的探讨特发性黄斑前膜(IMEM)患者光相干断层成像(OCT)显示视网膜结构变异程度及黄斑区视网膜厚度(RT)与患者视功能损害的相关性。方法回顾性分析经OCT检查确诊IMEM共56例66眼,进行最佳矫正视力(BCVA)、眼底及OCT检查,依据视网膜内部结构变异严重程度分为轻、中、重度组,并测量RT。结果轻、中、重度组患眼平均RT分别为(311.95±51.78)μm、(447.13±41.95)μm和(560.00±58.23)μm,依次增高,差异有统计学意义(均P<0.05);轻、中、重度组患眼平均BCVA分别为0.78±0.16、0.38±0.12和0.27±0.14,依次降低,差异有统计学意义(P<0.05);轻度组患眼RT与BCVA之间无线性相关性(r=-0.352,P=0.128),中、重度组内患眼RT与BCVA之间呈负相关(r分别为-0.768和-0.482,P<0.05)。结论黄斑区视网膜结构变异程度及RT可以反映视功能损害的程度,RT值达到400μm可以作为手术干预的客观标准。

Objective To investigate the correlation between retinal deformation degree and retina thickness (RT) detected by optic coherent tomography (OTC) in patients with idiopathic macular epiretinal membrane (IMEM). Methods The 66 eyes (56 patients) with IMEM diagnosed by OCT were retrospectively analyzed in this study. After best corrected visual acuity (BCVA), ocular fundus and OCT examination, patients were divided into three groups (mild, medium and severe) according to retinal deformation degrees. The RT value was measured manually. Results There were significant differences in RT values between mild, moderate and severe groups:(311.95 ±51.78) μm, (447.13±41.95) μm and (560.00± 58.23) μm (P<0.05). The values of BCVA were 0.78±0.16, 0.38±0.12 and 0.27±0.14 for mild, moderate and severe groups, there were significant differences between them (P<0.05). There was no significant correlation between RT and BCVA in mild group (r=-0.352,P=0.128). There was negative correlation between RT and BCVA in medium group and serious group (r=-0.768 and-0.482,P<0.05). Conclusion The retinal deformation degree and RT are two objective indicators to assess visual performance in patients of IMEM. When RT is more than 400 μm, it can be used as objective criteria for surgical intervention.