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巩膜节段性扣带术对孔源性视网膜脱离眼脉络膜血流和脉络膜形态的影响。

Change in choroidal blood flow and choroidal morphology due to segmental scleral buckling in eyes with rhegmatogenous retinal detachment.

机构信息

Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Sci Rep. 2017 Jul 20;7(1):5997. doi: 10.1038/s41598-017-05126-1.

Abstract

Although scleral buckling is a well-established surgical treatment for rhegmatogenous retinal detachment (RRD), the procedure can reportedly cause problems in the ocular circulation. Segmental scleral bucking without a concomitant encircling procedure was performed on 46 eyes with successfully reattached macula-on RRD. Choroidal blood flow was assessed using laser speckle flowgraphy. Spectral-domain optical coherence tomography was used to image macular regions, to measure the subfoveal choroidal thickness (SFCT), and to calculate the luminal and the stromal areas by the binarization method preoperatively and 1, 4, 8 and 12 weeks postoperatively. Choroidal mean blur rate at the macula did not significantly change, while that at the buckle and unbuckle side significantly reduced at 8 weeks postoperatively in the operated eye (P = 0.007 and P = 0.017, respectively). The SFCT and the luminal area increased temporarily 1 week following surgery in the operated eye (P < 0.001). The trend of SFCT with time coincided with that of the luminal area (P < 0.001). Venous drainage obstruction induced by compression force of scleral buckling leads to SFCT thickening in the acute postoperative phase. The macular choroidal blood flow might be less susceptible because the blood flow at the macula, in contrast to the other areas, does not change following segmental scleral buckling.

摘要

巩膜扣带术是治疗孔源性视网膜脱离(RRD)的一种成熟的手术治疗方法,但据报道该手术会引起眼循环问题。对 46 例成功复位的黄斑区视网膜脱离患者行节段性巩膜扣带术,不伴环扎术。采用激光散斑血流仪评估脉络膜血流。应用频域光学相干断层扫描(OCT)成像观察黄斑区,测量中心凹下脉络膜厚度(SFCT),并通过二值化方法术前及术后 1、4、8 和 12 周分别测量计算管腔和基质面积。术后 8 周,黄斑区脉络膜平均模糊率无显著变化,而扣带侧和非扣带侧脉络膜模糊率显著降低(分别为 P=0.007 和 P=0.017)。术后 1 周,患眼 SFCT 和管腔面积暂时增加(P<0.001)。SFCT 随时间的变化趋势与管腔面积一致(P<0.001)。巩膜扣带术的压缩力导致静脉引流阻塞,导致急性术后阶段 SFCT 增厚。由于与其他区域相比,黄斑区血流没有变化,因此黄斑脉络膜血流可能不太容易受到影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ede4/5519709/b9a5f7c60a2b/41598_2017_5126_Fig1_HTML.jpg

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