河北医科大学学报 ›› 2022, Vol. 43 ›› Issue (10): 1163-1166,1196.doi: 10.3969/j.issn.1007-3205.2022.10.010

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特发性黄斑裂孔术后视功能恢复与黄斑区毛细血管血流改变相关性分析

  

  1. 1.海南省三亚市人民医院眼科，海南 三亚 572000；2.海南医学院第一附属医院眼科，海南 海口 570100

  • 出版日期:2022-10-25 发布日期:2022-11-16
  • 作者简介:林小莉（1980-），女，海南三亚人，海南省三亚市人民医院主治医师，医学学士，从事眼科疾病诊治研究。
  • 基金资助:
    海南省卫生健康行业科研项目（20A200200）

Correlation analysis of visual function recovery with changes in blood flow of capillaries in the macula after idiopathic macular hole surgery

  1. 1.Department of Ophthalmology, Sanya People′s Hospital, Hainan Province, Sanya 572000, 
    China; 2.Department of Ophthalmology, the First Affiliated Hospital of Hainan Medical 
    University, Haikou 570100, China

  • Online:2022-10-25 Published:2022-11-16

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摘要： 目的 观察分析特发性黄斑裂孔（idiopathic macular hole，IMH）患者手术前后黄斑区毛细血管血流改变情况及与视力恢复的相关性。
方法 选取单眼IMH患者75例为观察组，将患侧眼作为A组，对侧健康眼作为B组，选取同期体检的健康者眼75例为对照组，观察比较3组患者治疗前黄斑中心凹无血管区面积（area of avascular area of fovea macula,FAZ）及FAZ中心视网膜浅层毛细血管（central superficial retinal capillary,RSCP）、视网膜深层毛细血管（deep retinal capillary ,RDCP）、脉络膜浅层毛细血管（superficial choroidal capillary,CSCP）血流面积和血流密度，观察A组治疗前及治疗后3个月、6个月相关指标和最佳矫正视力（best corrected vision,BCVA）恢复情况的相关性。
结果 术前B组、对照组FAZ低于对照组，RDCP血流密度、CSCP血流面积及血流密度高于A组，A组患者手术均成功完成，患者术后随访6个月，黄斑裂孔闭合率100%，患者BCVA术前（1.14±0.27）LogMAR，术后3个月为（0.87±0.15）LogMAR，术后6个月为（0.84±0.13）LogMAR。术后3个月、6个月FAZ低于术前，RDCP血流密度、CSCP血流面积及血流密度高于术前，差异均有统计学意义（P＜0.05），患者术后视力恢复情况与FAZ呈负相关性（P＜0.05），与RDCP血流密度、CSCP血流面积及血流密度呈正相关性（P＜0.05）。
结论 IMH患者黄斑裂孔的发生与FAZ及黄斑区毛细血管血流变换有密切的相关性，术后患者FAZ面积及视网膜深层毛细血管及脉络膜浅层毛细血管的血流密度和血流面积均得到明显改善，患者远期视力恢复与术后FAZ面积呈显著负相关性，与血流密度和血流面积呈正相关性，其可作为IMH患者术后视力恢复的良好预后指标。


关键词: 特发性黄斑裂孔, 最佳矫正视力, 毛细血管血流, 相关性分析

Abstract: Objective To observe and analyze the changes in blood flow of capillaries in the macula and their correlation with the visual function recovery in IMH patients after surgery. 
Methods A total of 75 patients with monocular IMH were selected as the observation group, with the affected eye as group A, and the contralateral healthy eye as group B. Another 75 eyes of healthy physical examinees were selected as the control group. The area of foveal avascular zone(FAZ) and blood flow area and blood flow density of superficial retinal capillaries(RSCP), deep retinal capillaries(RDCP), and superficial choroidal capillaries(CSCP) in the center of FAZ before treatment were observed and compared in the three groups, The correlation between related indicators and best corrected visual acuity(BCVA) recovery in group A before treatment and at 3 months and 6 months after treatment was observed. 
Results Before operation, FAZ of group B and control group was lower than that of control group. RDCP blood flow density, CSCP blood flow area and blood flow density were higher than those of group A, the operations of the patients in group A were successfully completed. The patients were followed up for 6 months after the operation. The macular hole closure rate was 100%. The patient's BCVA was (1.14±0.27) LogMAR before surgery, (0.87±0.15) LogMAR at 3 months after operation, and (0.84±0.13) at 6 months after operation. The FAZ at 3 and 6 months after the operation was lower than before the operation, RDCP blood flow density, CSCP blood flow area, and blood flow density were higher than those before surgery, and the differences were statistically significant(P＜0.05). The postoperative visual acuity recovery was negatively correlated with FAZ(P＜0.05), and positively correlated with RDCP blood flow density, CSCP blood flow area and blood flow density(P＜0.05).
Conclusion The occurrence of macular hole in IMH patients is closely related to FAZ and changes in macular blood flow. The area of FAZ and the blood flow density and blood flow area of RDCP and CSCP of the patients after the operation have been significantly improved. There is a significant negative correlation between the patient′s long-term vision recovery and postoperative FAZ area, and a positive correlation with blood flow density and blood flow area, which can be used as a good prognostic indicator for postoperative vision recovery in IMH patients.


Key words: idiopathic macular hole, best corrected visual acuity, capillary blood flow, correlation analysis

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