特发性黄斑孔术后孔未闭的OCT特征

The OCT characteristics of unclosed holes after operation of idiopathic macular holes

目的观察特发性黄斑孔术后孔未闭的OCT特征。方法回顾性分析2014年6月至2018年12月甘肃省人民医院眼科特发性黄斑孔施行玻璃体切除联合内界膜剥除及消毒空气填充而术后孔未闭的10例(10眼)的临床资料。比较术前、术后4 d、10 d、3周的OCT图像特征。结果10例中,黄斑孔直径200~400μm者1例,410~600μm者4例,600μm以上者5例。术前、术后4 d、10 d及3周黄斑孔最小径依次为(587.90±147.46)μm、(165.60±36.24)μm、(339.40±129.92)μm及(906.90±78.83)μm;基底径依次为(748.30±167.22)μm、(174.00±36.08)μm、(387.50±116.14)μm及(1094.80±84.84)μm;孔高度依次为(641.00±28.99)μm、(233.80±82.61)μm、(325.30±27.92)μm及(674.70±32.04)μm。术后4 d、10 d及3周各参数与术前相比较,差异均有统计学意义(P<0.05)。OCT表现为接近愈合的黄斑孔的最小径和基底径重新拉长,边缘高度增高,视网膜内核层和(或)外核层的低反射空腔重新出现。结论特发性黄斑孔术后未闭合孔有逐渐增大增高的趋势,OCT有特征性表现。

Objective To observe the OCT characteristics of the unclosed holes after operation of idiopathic macular holes.Methods This was a retrospective study.The clinical data of 10 eyes of 10 cases with unclosed idiopathic macular holes after surgery from Jun.2014 to Dec.2018 in Gansu Provincial Hospital were analyzed.All patients with idiopathic macular holes underwent vitrectomy,internal limiting membrane peeling and filtrated air tamponade.The characteristics of OCT images preoperatively and 4 days,10 days,3 weeks postoperatively were compared respectively.Results There was 1 case of hole diameter below 400μm,4 cases of 410-600μm,and 5 cases of more than 600μm.In order as follows:the minimum diameter before surgery,4 days,10 days and 3 weeks after surgery,were(587.90±147.46)μm,(165.60±36.24)μm,(339.40±129.92)μm and(906.90±78.83)μm;basal diameter were(748.30±167.22)μm,(174.00±36.08)μm,(387.50±116.14)μm and(1094.80±84.84)μm;height of macular hole were(641.00±28.99)μm、(233.80±82.61)μm,(325.30±27.92)μm and(674.70±32.04)μm.The parameters were compared with those before surgery,the differences were statistically significant(all P<0.05).OCT showed that the minimum diameter and basal diameter of the macular hole near healing were lengthened,the edge height increased,and the low reflection cavity of the inner and/or outer nuclear layer of the retina reappeared.Conclusion The unclosed hole has an increasing tendency gradually.OCT has characteristic manifestations.