特发性黄斑前膜手术前后黄斑区微血管OCTA形态观察

The morphological changes of macular capillaries under OCTA in patients with idiopathic macular membrane before and after surgery

目的:观察特发性黄斑前膜手术后视功能恢复情况和特发性黄斑前膜光学相干断层扫描血管成像(OCTA)的形态变化。方法:收集贵州医科大学附属医院确诊的特发性黄斑前膜患者25例,术前术后进行最佳矫正视力、眼前节、眼底、光学相干断层扫描(OCT)、OCTA等检查,根据OCTA血管形态进行分组,并进行25G玻璃体切割联合前膜及内界膜剥除术;采用SPSS22.0进行统计学分析术前术后最佳矫正视力(BCVA)的变化。结果:术后3月BCVA与术前比较,差异有统计学意义(P<0.05),血管扭曲组与非血管扭曲组术后BCVA比较,差异有统计学差异(P<0.05)。结论:玻璃体切割联合前膜及内界膜剥膜术是治疗特发性黄斑前膜的有效方法,在黄斑区微血管牵拉扭曲之前进行手术可获得更好的视功能。

Objective： To observe the recovery of visual function after surgery and the morphological changes under optical coherence tomography angiography（ OCTA） in patients with idiopathic macular membrane. Methods： We examined the records of 25 patients（25 eyes） with idiopathic macular epiretinal membrane and who has been treated in our department. A thorough ophthalmological examination,including the best corrected visual acuity,anterior segment,fundus,optical coherence tomography（ OCT）, OCTA,etc., was carried out.The groups were classified according to the OCTA vascular morphology before surgery. All patients underwent TSV25G（ 25 gauge transconjunctival sutureless vitrectomy） PPV（ pars plana vitrectomy） with membrane and ILM peeling. SPSS22.0 was used to statistically analyze difference between preoperative and postoperative best corrected visual acuity（ BCVA）. Results： The three-month postoperative BCVA was statistically different with preoperative BCVA（ P0.05）. Postoperative BCVA of distorted vascular group was statistically different with non-distorted vascular group（ P0.05）. Conclusion： PPV with membrane and ILM peeling is effective in treating idiopathic macular epiretinal membrane,and it ensures better visual function before vascular was distorted in macular area.