孔源性视网膜脱离术后黄斑区视网膜外核层厚度与视力关系的研究

Associations between retinal outer nuclear layer thickness and visual acuity after successful retinal detachment surgery

目的使用相干光层析成像术(OCT)分析孔源性视网膜脱离(RRD)患者硅油填充术后黄斑区视网膜外核层厚度与术后视力的相关性。方法研究纳入43例(43只眼)行玻璃体切除联合眼内硅油填充的RRD患者,根据视网膜脱离是否累及黄斑区,分为黄斑区脱离组(n=30)和黄斑区未脱离组(n=13)。分别于术前和术后3个月时行海德堡Spectralis OCT扫描,检查logMAR最佳矫正视力(BCVA),比较术前术后及两组之间黄斑中心凹处视网膜外核层厚度(ONLT),并使用Pearson相关分析进一步探讨其与术后视力的相关性。结果RRD患者术前ONLT平均为(102.96±33.79)μm,术后3个月时为(106.12±36.00)μm,患眼术前ONLT与术后3个月时的ONLT呈正相关(r=0.99,P<0.001)。患眼术后3个月的ONLT与最终的logMAR BCVA呈负相关(r=-0.73,P<0.001)。黄斑区脱离组术前术后ONLT均低于黄斑区未脱离组(均P<0.001)。黄斑区脱离组的术后视力同样也低于黄斑区未脱离组(P<0.001)。结论根据黄斑中心凹的ONLT可以预测RRD患者术后视力,黄斑区脱离型RRD患者术后ONLT和视力均低于未脱离型RRD。

Objective To analyze the associations between the macular retinal outer nuclear layer thickness and the postoperative visual acuity in patients with rhegmatogenous retinal detachment(RRD)after silicone oil tamponade by optical coherence tomography(OCT).Methods A total of 43 patients(43 eyes)with RRD who underwent pars plana vitrectomy and silicone oil tamponade were divided into the macular detachment group(n=30)and non-detachment group(n=13)according to whether retinal detachment involved the macular area.Spectralis OCT and the best corrected LogMAR visual acuity(BCVA)measurements were performed before and at three months after the surgery.The outer nuclear layer thickness(ONLT)in the fovea of macula was compared before and after the surgery and between the two groups.Pearson correlation analysis was used to further explore the associations between the ONLT and the postoperative visual acuity.Results The mean preoperative ONLT of RRD patients was 102.96±33.79μm,and 106.12±36.00μm at 3 months after the surgery.There was significant positive correlation between the preoperative and postoperative ONLT at 3 months(r=0.99,P<0.001).There was significant negative correlation between ONLT and the final LogMAR BCVA at 3 months after the surgery(r=-0.73,P<0.001).The ONLT and the postoperative visual acuity of the group with macular detachment were significantly lower than those of the group without macular detachment(P<0.001).Conclusions The ONLT of fovea can predict the postoperative visual acuity of patients with RRD.In addition,the ONLT and visual acuity of RRD patients with macular detachment are significantly lower than those without macular detachment.