频域相干光断层扫描观察不放液巩膜外加压术治疗孔源性视网膜脱离视网膜下液与视力的相关性

Spectral domain-OCT analysis of the macula after scleral buckling surgery for macula-off RRD

目的分析不放液巩膜外加压手术治疗累及黄斑区的孔源性视网膜脱离(RRD)术后应用频域相干光断层扫描(OCT)检测不同时期中心区视网膜厚度(CST)、黄斑中心凹视网膜下液厚度(SRF),分析其与最佳矫正视力变化(BCVA)的相关性。方法采用不放液巩膜外加压手术治疗27例27只眼,检测并比较术前及术后1周、1、3、6个月、1年BCVA,术后各时点的CST、黄斑中心凹SRF高度,并分析三者之间的相关性。结果所有患者术后视网膜均解剖复位,视力均有提高(P<0.05),且术后3个月以后BCVA提高不再明显。BCVA及黄斑中心凹SRF与术后时间呈负相关(P<0.05),但CST与BCVA的变化无关(P>0.05)。结论不放液巩膜外加压手术是治疗病变累及黄斑的单纯性孔源性视网膜脱离较理想的手术方法之一,术后3个月内视力恢复明显。术后CST及黄斑中心凹SRF厚度的改变与BCVA无明显相关性。

ObjectiveTo study the effectiveness of scleral buckling without subretinal fluid drainage for macula-on rhegmatogenous retinal detachment （RRD）, and to analyze the correlation between best-corrected visual acuity （BCVA） and the height of foveal subretinal fluid as well as the thickness of central retina measured by optical coherence tomography.MethodsThe medical records of 27 patients （27 eyes） who underwent scleral buckling without subretinal fluid drainage for macula-on RRD were retrospectively analyzed. The BCVA, height of foveal subretinal fluid and central subfield thickness （CST） were evaluated preoperatively and 1 week, 1 month, 3 months, 6 months and 12 months postoperatively.ResultsPostoperative BCVA of all eyes were improved significantly （P〈0.05）, and no significant improvement of BCVA was observed after 3 months postoperatively. After surgeries, the height of foveal subretinal fluid as well as the thickness of central foveal retina were correlated with the length of postoperative period significantly, respectively （P〈0.05）, but had no correlation with the improvement of postoperative BCVA （P〉0.05）.ConclusionsScleral buckling without subretinal fluid drainage for macula-off RRD improved the BCVA, especially in the first 3 months postoperatively. The postoperative alterations of subretinal fluid and central foveal retinal thickness had no correlation with BCVA.