眼挫伤黄斑结构改变与视力的相关性研究

Study on the correlation between the visual acuity and the changes of retinal structure of the macular in eyes with contusion

目的探讨眼挫伤黄斑区视网膜结构改变与视力之间的关系。方法对16例（16眼）眼挫伤应用频域光相干断层扫描（SD—OCT）检测黄斑区结构改变多种数值。观察挫伤眼与对侧正常眼之间的差异，并分析黄斑区改变与视力（BCVA）受损程度之间的相关性。结果黄斑中心区视网膜平均厚度挫伤眼比对侧眼薄，差异有统计学意义（P=0．003）。挫伤眼与对侧眼黄斑各区容积检测数值相比，除了外环鼻侧、下方、颞侧外，其余各区差异有统计学意义（P=0．008、0．001、0．002、0．017、0．020、0．010、0．002、0．014）。黄斑中心区容积，黄斑旁中心内环区容积，黄斑中心区视网膜厚度值与视力间均呈负相关（P：0．000、0．044、0．008）。黄斑部总容积与视力间无相关性（P=0．194）。平均椭圆体带中断的长度与视力之间呈正相关（P=0．043）。多重线性回归分析显示，视力随着黄斑中心区容积的下降而下降（Y=-9．636X＋2．471，R^2=0．896，R^ad=0．878，P=0．000）。结论眼挫伤后黄斑部容积，黄斑中心区厚度及视网膜内反射光带中断的长度等视网膜结构的改变与视力受损程度之间密切相关。黄斑中心区视网膜容积可以反映视功能损害的严重程度。

Objective To investigate the correlation between the visual acuity and the changes of retinal structure of the macular in eyes with contusion. Methods Sixteen eyes of 16 patients with ocular contusion were collected in this study. Frequency domain optical coherence tomography （SD-OCT） were used to measure the changes of shape and structure of the macular. The difference was observed between contusion eyes and contralateral normal eyes. The relationship between the degree of impaired BCVA and the foveal change was analysed. Results The average thickness of central macula in contusion eyes was thinner than in contral eyes, the difference was statistically significant （ P = 0. 003 ）. The difference in macular volume between contusion eyes and contralateral eyes was statistically significant（ P = 0. 008,0. 001,0. 002, 0. 017 ,0. 020,0. 010,0.002,0. 014） in all other areas except the ring side, below the nose and temporal. Macular volume, macula paracentral inner ring volume and average central macular retinal thickness were negatively correlated with vision （ P = 0. 000,0. 044,0. 008 ）. Macular total volume showed no correlation with vision（ P = 0. 194）. The length of ellipsoid interrupted had a positive correlation with vision （ P = 0. 043）. Multiple linear regression analysis showed, visual acuity was drop with decreasing of the volume of macular （Y= -9. 636X ＋2. 471 ,R2 =0. 896,R2d =0. 878,P =0. 000）. Conclusion After ocular contusion, the changes of retinal morphology and structure such as macular volume ,foveal thickness ,the length of retinal internal reflection band are closely related to the degree of retinal damage. Macular retinal region volume can reflect the severity of the damage of visual function.