From the University of California-Davis, Sacramento, California, USA.
From the University of California-Davis, Sacramento, California, USA.
J Cataract Refract Surg. 2014 Apr;40(4):626-31. doi: 10.1016/j.jcrs.2013.09.018. Epub 2014 Feb 14.
To use ultra-high-resolution optical coherence tomography (OCT) subclinical anatomic alterations to explain suboptimum vision despite pseudophakic cystoid macula edema (CME) resolution.
University of California-Davis, Sacramento, California, USA.
Case study.
This study comprised patients who had cataract phacoemulsification surgery. Cases of resolved postoperative CME (diagnosed postoperatively by 1 month and resolved by 1 year) were included. Exclusion criteria included any other cause for decreased vision or compounding factors. Patients with a history of resolved pseudophakic CME were imaged using a purpose-built ultra-high-resolution OCT system with 4.5 μm axial resolution and an acquisition speed of 9 frames/sec (1000 A-scans/frame). The corrected distance visual acuity (CDVA) was determined by Early Treatment Diabetic Retinopathy Study standards. Statistical analysis was by the unpaired t test. A P value less than 0.05 was considered significant.
The review identified 56 patients with a pseudophakic CME diagnosis at least 1 month postoperatively. Fifteen eyes (26.8%) had less than 20/20 CDVA despite resolution of CME; 7 participated. Four patients with 20/20 CDVA after resolution of pseudophakic CME participated. Eyes with reduced CDVA after macula edema showed ultra-high-resolution OCT evidence of blurring of outer segments of photoreceptors, while controls showed normal outer retina morphology (P<.05).
Persistent anatomic alteration of photoreceptors visualized by ultra-high-resolution OCT correlated with reduced CDVA in patients with pseudophakic CME compared with patients who had 20/20 CDVA after macula edema. This anatomic alteration in outer photoreceptor morphology is a plausible explanation for the reduced CDVA in this disease.
No author has a financial or proprietary interest in any material or method mentioned.
利用超高分辨率光相干断层扫描（OCT）的亚临床解剖学改变，解释在假性囊泡性黄斑水肿（CME）消退后，视力仍不理想的原因。
美国加利福尼亚大学戴维斯分校萨克拉门托分校。
病例研究。
本研究纳入了接受白内障超声乳化手术的患者。纳入的病例为术后 CME 已消退（术后 1 个月诊断，1 年内消退）。排除标准包括任何其他导致视力下降的原因或复合因素。有复发性假性囊泡性 CME 病史的患者使用专门设计的超高分辨率 OCT 系统进行成像，该系统具有 4.5μm 的轴向分辨率和 9 帧/秒的采集速度（每帧 1000 个 A 扫描）。矫正后的远视力（CDVA）根据早期糖尿病视网膜病变治疗研究标准确定。采用配对 t 检验进行统计分析。P 值小于 0.05 被认为具有统计学意义。
本次回顾性研究共纳入了 56 例术后至少 1 个月诊断为假性囊泡性 CME 的患者。15 只眼（26.8%）尽管 CME 已消退，但仍低于 20/20 CDVA；7 只眼参与了研究。4 只眼在假性囊泡性 CME 消退后达到 20/20 CDVA 参与了研究。黄斑水肿消退后 CDVA 降低的眼，超高分辨率 OCT 显示外节光感受器模糊，而对照组显示正常的外视网膜形态（P<.05）。
与黄斑水肿后视力达到 20/20 的患者相比，假性囊泡性 CME 患者中，超高分辨率 OCT 观察到的光感受器持续的解剖学改变与 CDVA 降低相关。这种外光感受器形态的解剖学改变是该疾病 CDVA 降低的一个合理解释。
没有作者对任何材料或方法有财务或所有权利益。
