黄斑裂孔和黄斑前膜手术后的阅读能力与视网膜敏感度

Reading ability and retinal sensitivity after surgery for macular hole and macular pucker.

作者信息

Cappello Ezio, Virgili Gianni, Tollot Luigina, Del Borrello Michele, Menchini Ugo, Zemella Marco

机构信息

Eye Clinic, San Martino Hospital, Belluno, Italy.

出版信息

Retina. 2009 Sep;29(8):1111-8. doi: 10.1097/IAE.0b013e3181a3b832.

DOI:10.1097/IAE.0b013e3181a3b832

PMID:19491726

Abstract

PURPOSE

To assess whether reading ability and microperimetry improve as demonstrated for visual acuity after surgery for macular hole and macular pucker.

METHODS

Fifty-nine consecutive patients underwent pars plana vitrectomy for macular pucker (n = 41) or full-thickness macular holes (n = 18). Functional assessment was made at 3, 6, and 12 months after surgery and included far visual acuity (Early Treatment Diabetic Retinopathy Study charts), retinal sensitivity using the microperimeter (MP1, Nidek Technologies, Padova, Italy), and reading ability (MNRead charts).

RESULTS

An improvement was recorded both for macular holes and puckers not only for visual acuity, but also for reading acuity and mean central retinal sensitivity (P < 0.01 for the overall comparisons between baseline and follow-up values). Maximum reading speed was already good at baseline both for puckers and holes overall, and a significant mean improvement was recorded only in patients with macular hole at 6 and 12 months (P < 0.01). Although eyes with macular holes had worse baseline visual function compared with puckers (P < 0.01 for all measures of visual function except for reading speed), they recovered to similar levels thanks to greater improvement (P < 0.05 for the difference in improvement during follow-up between puckers and holes for all measures of visual function). No differences were found among indocyanine green or trypan blue staining compared with no staining for internal limiting membrane removal based on all outcome measures (P > 0.05 for the overall difference of visual function improvement during follow-up).

CONCLUSION

The improvement found for visual acuity after vitrectomy for macular hole and pucker also regards retinal sensitivity and reading ability for up to 12 months. This is reassuring concerning the benefits for the patients, and this shows that visual acuity is a valid functional measure for investigating the efficacy of macular surgery.

摘要

目的

评估黄斑裂孔和黄斑前膜手术后，阅读能力和微视野检查是否如视力改善那样得到改善。

方法

连续59例患者接受了黄斑前膜（n = 41）或全层黄斑裂孔（n = 18）的玻璃体切除术。在术后3、6和12个月进行功能评估，包括远视力（早期糖尿病视网膜病变研究视力表）、使用微视野计（MP1，尼德克科技公司，意大利帕多瓦）测量视网膜敏感度，以及阅读能力（MNRead视力表）。

结果

黄斑裂孔和黄斑前膜患者不仅视力有所改善，阅读视力和平均中心视网膜敏感度也有所提高（基线值与随访值的总体比较，P < 0.01）。总体而言，黄斑前膜和黄斑裂孔患者的最大阅读速度在基线时就已经较好，仅黄斑裂孔患者在6个月和12个月时平均阅读速度有显著提高（P < 0.01）。尽管黄斑裂孔患者的基线视觉功能比黄斑前膜患者差（除阅读速度外，所有视觉功能指标的P < 0.01），但由于改善程度更大，他们恢复到了相似水平（所有视觉功能指标在随访期间黄斑前膜和黄斑裂孔改善差异的P < 0.05）。基于所有结果指标，与不使用吲哚青绿或台盼蓝染色进行内界膜剥除相比，使用这两种染料染色之间未发现差异（随访期间视觉功能改善的总体差异，P > 0.05）。