玻璃体激光消融治疗对黄斑微循环影响的临床研究

Study on the changes of vitreous laser ablation on macular microcirculation

研究目的:研究YAG激光消融治疗对生理性玻璃体混浊黄斑微循环的影响。方法:筛选我院32例生理性玻璃体混浊患者,均行YAG激光消融治疗,术前检查最佳矫正视力(BCVA)、非接触眼压、眼部B超、间接眼底镜、OCTA测量黄斑中心凹无血管区(foveal avascular zone,FAZ)面积和黄斑区血流密度(macular vascular density,MVD),观察对比术后30 min、1周、1月、3月、6月以上检查的变化。结果:治疗前后患者的BCVA与非接触眼压无明显差异(P>0.05),玻璃体腔内的混浊物经治疗后明显变小,未发现明显的黄斑拱环形态改变及微血管异常改变。视网膜浅层黄斑区中心、内层、完整区域血管长度密度、血管灌注密度差异均无明显差异(P>0.05)。结论:YAG激光消融治疗能够安全有效改善玻璃体混浊症状,且对患眼视力、眼压和黄斑区微循环无不良影响。

Objective:To study the effect of YAG laser ablation on macular microcirculation.in physiologic vitreous opacity.Methods:The selected 32 patients of physiological vitreous floaters,all of them were treated by YAG laser ablation in our hospital,.Were checked for best corrected visual acuity(BCVA),non-contact intraocular pressure,ocular b-ultrasound,indirect ophthalmoscopy,to measure the foveal avascular zone and macular vascular density using optical coherence tomography angiography(OCTA)before and 30 minutes after surgery,1 week after surgery,3 months after surgery,and 6 months after surgery.Observe and compare the changes of the above checks.Results:BCVA and non-contact intraocular pressure had no significant difference between before and after treatment(P>0.05).The vitreous floaters obviously decreases,after treatment.No obvious morphological changes of macular arch ring were found,no microvascular abnormalities were found.There were no significant differences in blood vessel length density and perfusion density in the central,inner and complete areas of superficial macular area.Conclusion:YAG laser ablation can safely and effectively improve the symptoms of vitreous opacity,and has no adverse effects on the visual acuity,intraocular pressure and macular microcirculation.