特发性黄斑视网膜前膜手术前后黄斑厚度与功能的对比研究

[A comparative study of macular thickness and function before and after idiopathic macular epiretinal membrane surgery].

作者信息

Zhou Jing, Liu Wu, Li Qian, Li Xiang, Hao Jing, Wang Xin-lei

机构信息

Capital Medical University, Beijing, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2012 Feb;48(2):119-23.

PMID:22490946

Abstract

OBJECTIVE

To compare the thickness and functional changes of the macula after idiopathic macular epiretinal membrane (IEM) surgery.

METHODS

A retrospective study. Thirty-seven patients (37 eyes) received surgical treatment of IEM. All patients received standard three-port vitrectomy as well as epiretinal membrane peeling. The best corrected visual acuity (BCVA, LogMAR) were recorded and optical coherence tomography (OCT) were used to evaluate central foveal thickness (CFT). Microperimetry (MP)-1 was used for the mean sensitivity (MS) of central 10° macula area. SPSS13.0 was used for statistical analysis. Rank and testing methods were used to compare the preoperative and postoperative BCVA, paired t testing method was used to compare the preoperative and postoperative CFT and MS values. Correlation analysis was used to study the BCVA, CFT, and MS. Pearson correlation analysis was applied to analyze measurement data and Spearman rank correlation analysis was used to analyze rating data.

RESULTS

Postoperatively, the BCVA (0.1 - 0.7, median 0.4) was significantly better (Z = -4.97, P < 0.05) than the preoperative one (0.3 - 1.3, median 0.7). The CFT (246.2 ± 60.4) µm was significantly thinner (t = 15.86, P < 0.05) than the preoperative one (482.2 ± 101.8)µm. The MS of central 10° macula area (18.6 ± 1.8) dB was significantly higher (t = -9.20, P < 0.05) than the preoperative one (14.1 ± 3.4) dB. Thicker preoperative CFT was associated with a lower preoperative BCVA (r(s) = 0.91, P < 0.05), a lower MS of central 10° macula area (r = -0.82, P < 0.05) and a lower postoperative BCVA level (r(s) = 0.63, P < 0.05). But with a significant postoperative CFT reduce (r = 0.81, P < 0.05) and a significant postoperative BCVA increase (r(s) = 0.71, P < 0.05).

CONCLUSIONS

Vitrectomy combined with macular epiretinal membrane removal can effectively promote the recovery of macular thickness and function in patients with IEM. Examination and analysis of preoperative CFT, BCVA and MS of macula area may help to predict the recovery of CFT and function objectively in patients of IEM.

摘要

目的

比较特发性黄斑视网膜前膜（IEM）手术后黄斑的厚度及功能变化。

方法

一项回顾性研究。37例患者（37只眼）接受了IEM手术治疗。所有患者均接受标准三通道玻璃体切除术及视网膜前膜剥除术。记录最佳矫正视力（BCVA，LogMAR），并使用光学相干断层扫描（OCT）评估中心凹厚度（CFT）。使用微视野计（MP）-1测量黄斑中心10°区域的平均敏感度（MS）。采用SPSS13.0进行统计分析。采用秩和检验方法比较术前和术后的BCVA，采用配对t检验方法比较术前和术后的CFT及MS值。采用相关性分析研究BCVA、CFT和MS之间的关系。计量资料采用Pearson相关分析，等级资料采用Spearman秩相关分析。

结果

术后BCVA（0.1 - 0.7，中位数0.4）显著优于术前（0.3 - 1.3，中位数0.7）（Z = -4.97，P < 0.05）。CFT（246.2 ± 60.4）μm显著薄于术前（482.2 ± 101.8）μm（t = 15.86，P < 0.05）。黄斑中心10°区域的MS（18.6 ± 1.8）dB显著高于术前（14.1 ± 3.4）dB（t = -9.20，P < 0.05）。术前CFT越厚，术前BCVA越低（r(s) = 0.91，P < 0.05），黄斑中心10°区域的MS越低（r = -0.82，P < 0.05），术后BCVA水平越低（r(s) = 0.63，P < 0.05）。但术后CFT显著降低（r = 0.81，P < 0.05），术后BCVA显著提高（r(s) = 0.71，P < 0.05）。