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黄斑裂孔手术后视网膜敏感性和血管密度的变化:采用上方反转内界膜瓣技术。

RETINAL SENSITIVITY AND VESSEL DENSITY AFTER MACULAR HOLE SURGERY WITH THE SUPERIOR INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE.

机构信息

Departments of Ophthalmology.

Retinal Disease Control, and.

出版信息

Retina. 2021 Jan 1;41(1):45-53. doi: 10.1097/IAE.0000000000002839.

Abstract

PURPOSE

To evaluate retinal vessel density and retinal sensitivity (RS) after macular hole surgery with the superior inverted internal limiting membrane flap technique.

METHODS

Retrospective, observational case series. Twenty-one patients with idiopathic macular hole underwent 27-gauge vitrectomy with the superior inverted internal limiting membrane flap technique and triamcinolone acetonide. Measurements included RS, which was measured with microperimetry, as well as retinal vessel density in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), which was measured with optical coherence tomography angiography. All parameters were evaluated in the superior and inferior sectors of the macula preoperatively and 1, 3, and 6 months postoperatively.

RESULTS

Six months postoperatively, retinal thickness in the inferior sector was unchanged, but retinal thickness in the superior sector decreased significantly (P < 0.01). SCP vessel density in both sectors was unchanged at all postoperative time points. DCP vessel density in both sectors increased very significantly at 3 months (P < 0.01) and returned to baseline at 6 months. RS in the inferior sector increased by 47% 3 months postoperatively and by 61% 6 months postoperatively (P < 0.05 and P < 0.001, respectively), but RS in the superior sector increased only at 6 months postoperatively and only by 22% (P < 0.05).

CONCLUSION

Lower recovery of RS in the superior sector suggests that internal limiting membrane peeling might affect the postoperative visual function.

摘要

目的

评估采用上方反转内界膜瓣技术治疗黄斑裂孔后视网膜血管密度和视网膜敏感度(RS)的变化。

方法

回顾性观察性病例系列研究。21 例特发性黄斑裂孔患者接受 27G 玻璃体切割术联合上方反转内界膜瓣技术和曲安奈德治疗。测量指标包括使用微视野计测量的 RS,以及使用光相干断层扫描血管造影测量的浅层毛细血管丛(SCP)和深层毛细血管丛(DCP)的视网膜血管密度。所有参数在术前和术后 1、3 和 6 个月时分别在黄斑的上方和下方区域进行评估。

结果

术后 6 个月时,下方区域的视网膜厚度没有变化,但上方区域的视网膜厚度显著下降(P < 0.01)。两个区域的 SCP 血管密度在所有术后时间点均无变化。两个区域的 DCP 血管密度在术后 3 个月时显著增加(P < 0.01),并在 6 个月时恢复到基线水平。下方区域的 RS 在术后 3 个月时增加了 47%,在术后 6 个月时增加了 61%(P < 0.05 和 P < 0.001),而上方区域的 RS 仅在术后 6 个月时增加,仅增加了 22%(P < 0.05)。

结论

上方区域 RS 恢复较低表明内界膜剥除可能影响术后视觉功能。

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