硅油填充术后新发黄斑水肿的临床及频域光学相干断层扫描结果与变化

Clinical and spectral-domain optical coherence tomography findings and changes in new-onset macular edema after silicone oil tamponade.

作者信息

Bai Jun-Xing, Zheng Xin, Zhu Xiao-Qing, Peng Xiao-Yan

机构信息

Department of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmolgy and Visual Science Key Laboratory, Capital Medical University, No.1 Dongjiaomin Alley, Dongcheng District, Beijing, 100730, People's Republic of China.

Department of Ophthalmology, Beijing Hua-er Hospital, No.59 Xizongbu Lane, Dongcheng District, Beijing, 100005, People's Republic of China.

出版信息

BMC Ophthalmol. 2025 Mar 27;25(1):153. doi: 10.1186/s12886-025-03986-0.

DOI:10.1186/s12886-025-03986-0

PMID:40148832

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11951619/

Abstract

BACKGROUD

Few investigations have been conducted on the detailed clinical features of CME associated with SiO, from emergence to restoration, especially using OCT images. This study aimed to analyze the clinical and spectral-domain optical coherence tomography (SD-OCT) characteristics and changes in cystoid macular edema (CME) associated with silicone oil (SiO).

METHODS

Retrospective case series. Six cases of newly on-set CME after SiO tamponade were examined. SD-OCT was performed before pars plana vitrectomy, after SiO tamponade, and after SiO removal. Clinical and SD-OCT data was collected.

RESULTS

CME was first noted at 28.83 ± 9.22 days after SiO tamponade. The average foveal thickness was 411 ± 41 μm before oil removal and decreased to 267 ± 69 μm three days after oil removal (P = 0.028). The average visual acuity before and after oil removal were 0.82 ± 0.40 logarithm of the minimum angle of resolution (logMAR) and 0.75 ± 0.45 logMAR, respectively, and the difference was not statistically significant (P = 0.285). SD-OCT revealed that three patients had edema first in the inner nuclear layer (INL), and three had cysts in both INL and outer nuclear layers (ONL) at discovery. Of the six patients, three exhibited cystic changes in the fovea firstly. CME showed rapid recovery following SiO removal, with cysts completely disappearing in four patients (66.7%) within 3 days. However, in two patients (33.3%), the cysts persisted in INL after three days, whereas the cysts in ONL had resolved completely. The ellipsoid zone integrity of the macular region was smoother in patient with better vision.

CONCLUSION

New-onset CME after SiO tamponade may initially affects INL and then ONL. CME shows significant improvement after oil removal, probably initially resolving in ONL, and then followed by INL. SD-OCT enabless monitoring of macular microstructure changes in SiO-treated eyes, and macular cysts' occurrence can indicate the oil removal need.

摘要

背景

关于与硅油相关的黄斑囊样水肿（CME）从出现到恢复的详细临床特征，尤其是使用光学相干断层扫描（OCT）图像进行的研究较少。本研究旨在分析与硅油（SiO）相关的黄斑囊样水肿（CME）的临床和光谱域光学相干断层扫描（SD-OCT）特征及变化。

方法

回顾性病例系列研究。对6例硅油填塞后新发CME的患者进行检查。在玻璃体切除术前、硅油填塞后及硅油取出后进行SD-OCT检查。收集临床和SD-OCT数据。

结果

CME在硅油填塞后28.83±9.22天首次被发现。取出硅油前平均黄斑中心凹厚度为411±41μm，取出硅油3天后降至267±69μm（P = 0.028）。取出硅油前后平均视力分别为0.82±0.40最小分辨角对数（logMAR）和0.75±0.45 logMAR，差异无统计学意义（P = 0.285）。SD-OCT显示，3例患者最初在内核层（INL）出现水肿，3例患者在发现时INL和外核层（ONL）均有囊肿。6例患者中，3例首先在黄斑中心凹出现囊性改变。CME在取出硅油后迅速恢复，4例患者（66.7%）在3天内囊肿完全消失。然而,2例患者（33.3%）在3天后INL仍有囊肿，而ONL的囊肿已完全消退。视力较好的患者黄斑区椭圆体带完整性更平滑。