不同病因致黄斑囊样水肿患者视力下降与水肿形态的相关性分析(英文)

Correlation of patterns and etiologies with visual acuity in cystoid macular edema

目的:探讨囊样黄斑水肿(CME)患者光学相干断层扫描(OCT)形态,病因学和视力之间的关系。方法:本研究共搜集了本院门诊CME患者52例57眼,患者均应用OCT确诊为黄斑囊样水肿,且在同1d进行眼底及最佳矫正视力检查。最佳矫正视力(BCVA)检查使用E视力表和对数视力表(logMAR),视力范围2.3 logM AR^0logM AR(均数1.11±0.57)。通过患者病史和眼底照相进行病因诊断,根据黄斑囊样水肿最大垂直直径和黄斑厚度比率将OCT分为四级(一级<30%,30%≤二级<60%,60%≤三级<90%,四级≥90%),相关性是通过计算皮尔逊相关系数"r"值(P<0.05时有统计学意义)。结果:OCT IV级患者视力最差(平均视力1.96±0.23logMAR),此时OCT分级与视力之间有显著正相关,统计学有显著差异(r=0.729,P<0.001)。视网膜中央静脉阻塞(CRVO)是引起视力严重下降最常见的疾病,(r=0.375,P=0.004)。另外根据OCT的形态,IS/OS层(inner segment/outer segment)和ELM(external limiting membrane)均破环的患者视力显著下降(平均视力1.11±0.57 logM AR),二者间具有统计学差异(r=-0.346,P=0.008)。玻璃体视网膜牵拉和外视网膜层破坏均与OCTⅣ级和(r=0.390,P=0.003)CRVO呈正相关(r=0.362,P=0.006),差异有统计学意义。结论:当CME的OCT形态表现Ⅳ级时CRVO患者视力最差。

AIM： To determine the relation between each of the optical coherence tom ography（ OCT） patterns,etiologies and visual acuity in patients with cystoid m acular edem a（ CME）.METHODS： Fifty-seven eyes with CME from 52 patients were included in our study. The data of this cross sectional study was collected from patients with CME assessed by OCT, who also underwent fundus photography and visual acuity test the sam e day. The best corrected visual acuity（ BCVA） was assessed by using E chart and converted in logarithm of the m inim um angle of resolution（ log MAR）. The visual acuity varied from 2. 3 log MAR to 0 log MAR with a m ean of 1. 11±0. 57.The etiology was determ ined from m edical history and the fundus photograph of the patient. Four OCT grades established according to ratio between the vertical size of largest cyst and the m axim um m acular thickness（ 30%,≥30% 60%,≥60% 90% and ≥90%） were considered.The correlation was established by calculating the Pearson＇s correlation coefficient ＂r ＂ and the statistical significance was considered when P value was inferior to0. 05.RESULTS： OCT grade IV was the most associated with very severe visual loss with the greatest m ean VA of 1. 96±0. 23 log MAR and the correlation between OCT grades and visual acuity was strongly statistically significant（ r =0. 729,P 0. 001）. The central retinal vein occlusion（ CRVO） was the most underlying disease associated with worse vision,with the greatest m ean VA of 2 log MAR and the correlation was statistically significant（ r = 0. 375,P =0. 004）. Another associated OCT pattern,the disruption of both inner segm ent / outer segm ent（ IS / OS） and external lim iting m em brane（ ELM）,was inversely associated with severe visual loss（ high m ean VA = 1. 11 ± 0. 57 log MAR,with statistically significant correlation,r =-0. 346,P =0. 008）. The presence of both vitreoretinal traction com ponents and outer retinal layers disruption were significantly associated with OCT grade IV（ r = 0. 390,P =0. 003） and CRVO（ r = 0. 362,P= 0. 006）.CONCLUSION： In this study,the OCT fourth grade and CRVO seem to be m ore significantly associated with the worse vision in patients with CME.