[1]牛丽丽,胡俊喜.玻璃体切割硅油填充术后孔源性视网膜脱离患者黄斑区视网膜厚度及视功能变化[J].新乡医学院学报,2019,36(7):657-661.[doi:10.7683/xxyxyxb.2019.07.014]
　NIU Li-li,HU Jun-xi.Changes of macular retinal thickness and visual function in patients with rhegmatogenous retinal detachment after vitrectomy and silicone oil tamponade[J].Journal of Xinxiang Medical University,2019,36(7):657-661.[doi:10.7683/xxyxyxb.2019.07.014]
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玻璃体切割硅油填充术后孔源性视网膜脱离患者黄斑区视网膜厚度及视功能变化
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年7
页码:
657-661
栏目:
临床研究
出版日期:
2019-07-05

文章信息/Info

Title:
Changes of macular retinal thickness and visual function in patients with rhegmatogenous retinal detachment after vitrectomy and silicone oil tamponade
作者:
牛丽丽; 胡俊喜
(新乡医学院第一附属医院眼科，河南　卫辉　453100）
Author(s):
NIU Li-li; HU Jun-xi
(Department of Ophthalmology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China）
关键词:
孔源性视网膜脱离; 视网膜厚度; 硅油填充; 气体填充
Keywords:
rhegmatogenous retinal detachment; retinal thickness; silicone oil filling; gas loading
分类号:
R774.1
DOI:
10.7683/xxyxyxb.2019.07.014
文献标志码:
A
摘要:
目的　探讨硅油对孔源性视网膜脱离患者黄斑区视网膜厚度及视功能的影响。方法　选择2017年3月至2018年2月新乡医学院第一附属医院眼科收治的未累及黄斑区的孔源性视网膜脱离患者45例，均为单眼发病，根据治疗方法分为硅油填充组25例和气体填充组20例，2组患者均施行玻璃体切割，硅油填充组患者玻璃体腔内注入5 mL硅油，气体填充组玻璃体腔内注入5 mL无菌空气，均于术前、术后1周及术后1、3、6个月检测2组患者的最佳矫正视力(BCVA)，并行光学相干断层成像检查，比较2组患者黄斑中央凹区及内环区鼻侧、颞侧、上方、下方视网膜厚度。结果　2组患者术后1周患眼BCVA与术前比较差异无统计学意义（P>0.05）；术后1、3个月，2组患者患眼BCVA均优于术前和术后1周（P<0.05）；术后6个月，硅油填充组患者患眼BCVA差于术后1、3个月（P<0.05），与术前和术后1周比较差异无统计学意义（P>0.05）；术后6个月，气体填充组患者患眼BCVA优于术前和术后1周（P<0.05），与术后1、3个月比较差异无统计学意义（P>0.05）。术前、术后1周及术后1、3个月，2组患者患眼BCVA比较差异均无统计学意义（P>0.05）；术后6个月，气体填充组患者患眼BCVA优于硅油填充组（P<0.05）。术前、术后1周及术后1、3个月，2组患者之间患眼黄斑中央凹区及内环区各区域视网膜厚度比较差异均无统计学意义（P>0.05）；术后6个月,气体填充组患者患眼黄斑中央凹区及内环区鼻侧、颞侧、下方视网膜厚度显著大于硅油填充组（P<0.05）。2组患者术后1周患眼黄斑中央凹区及内环区各区域视网膜厚度均显著大于术前（P<0.05)。2组患者术后1、3个月患眼黄斑中央凹区及内环区各区域视网膜厚度均显著小于术后1周（P<0.05），而与术前比较差异无统计学意义（P>0.05）。2组患者术后6个月患眼黄斑中央凹区及内环区各区域视网膜厚度均显著小于术后1周（P<0.05）；硅油填充组患者术后6个月患眼黄斑中央凹区及内环区鼻侧、颞侧、下方视网膜厚度显著小于术前及术后1、3个月（P<0.05），气体填充组患者术后6个月患眼黄斑中央凹区及内环区各区域视网膜厚度与术前及术后1、3个月比较差异均无统计学意义（P>0.05）。结论　硅油可导致视网膜厚度降低，进而影响患者视力的恢复。
Abstract:
Objective　To investigate the effect of silicone oil on retinal thickness and visual function of macular region in patients with rhegmatogenous retinal detachment.Methods　Forty unilateral rhegmatogenous retinal detachment patients who were not involved in macular area in the First Affiliated Hospital of Xinxiang Medical University from March 2017 to February 2018 were selected.The patients were divided into silicone oil filling group(n=25) and gas filling group (n=20) according to the treatment method.All patients were given vitrectomy.The 5 mL silicone oil was injected into the vitreous cavity of patients in the silicone oil filling group and 5 mL sterile air was injected into the vitreous cavity of patients in the gas filling group.The best corrected visual acuity (BCVA) of all patients was detected before treatment and at one week,1,3,6 months after operation;the retinal thickness at macular fovea and nasal,temporal,superior and inferior of inner ring region of patients in the two groups were detected by optical coherence tomography before treatment and at one week,1,3,6 months after operation.Results　There was no significant difference in the BCVA between preoperation and one week after operation in the two groups (P>0.05);the BCVA at 1,3 months after operation was better than that at operation and one week after operation in the two groups (P<0.05).In the silicone oil filling group,the BCVA at 1,3 months after operation was better than that at 6 months after operation (P<0.05);there was no significant difference in the BCVA between 6 months after operation and preoperation and one week after operation(P>0.05).In the gas filling group,there was no significant difference in the BCVA between 6 months after operation and 1,3 months after operation(P>0.05);the BCVA at 6 months after operation was better than that before operation and one week after operation (P<0.05).There was no significant difference in the BCVA between the two groups before operation,one week after operation and 1,3 months after operation(P>0.05).The BCVA of patients in the gas filling group was better than that in the silicone oil filling group at 6 months after operation(P<0.05).There was no significant difference in the retinal thickness in the central concave area and inner ring area of the macular region between the two groups before operation,one week after operation and 1,3 months after operation (P>0.05).The retinal thickness in the nasal side,temporal side and inferior retina in the central concave area and inner ring area of the affected eyes in the gas filling group was significantly thicker than that in the silicone oil filling group at 6 months after operation (P<0.05).The retinal thickness in the central concave area and inner ring area of macular area at one week after operation was significantly thicker than that before operation in the two groups (P<0.05).The retinal thickness in the central concave area and inner ring area of macular area at 1,3 months after operation was thinner than that at one week after operation in the two groups (P<0.05);there was no significant difference in the retinal thickness in the central concave area and inner ring area of macular area at 1,3 months after operation and before operation in the two groups (P>0.05).The retinal thickness in the central concave area and inner ring area of macular area at 6 months after operation was thinner than that at one week after operation in the two groups (P<0.05).The retinal thickness in the nasal side,temporal side and inferior retina in the central concave area and inner ring area of the affected eyes at 6 months after operation was thinner than before operation and 1,3 months after operation in the silicone oil filling group (P<0.05).There was no significant difference in the retinal thickness in the central concave area and inner ring area of macular area between 6 months after operation,preoperation and 1,3 months after operation in the gas filling group(P>0.05).Conclusion　Silicone oil can decrease the retinal thickness and affects the recovery of visual acuity.

参考文献/References:

［1］　KWON O W,SONG J H.Retinal detachment and proliferative vitreoretinopathy［J］.Dev Ophthalmol,2016,55(2):154-162.
［2］　QIAN Z,XU K,KONG X.Ahmed glaucoma valves versus EX-press devices in glaucoma secondary to silicone oil emulsification［J］.J Ophthalmol,2018,2018(5):8539689.
［3］　JABBOUR E,AZAR G,ANTOUN J,et al.Incidence and risk factors of ocular hypertension following pars plana vitrectomy and silicone oil injection［J］.Ophthalmologica,2018,240(3):129-134.
［4］　TANAKA Y,TOYODA F,SHIMMURA-TOMITA M,et al.Clini-copathological features of epiretinal membranes in eyes filled with silicone oil［J］.Clin Ophthalmol,2018,12(3):1949-1957.
［5］　MACGREGOR C,JONAS A,HANIFUDIN A.Ratios for double silicone oil Endotamponade-in vitro observations may assist with ratio selection［J］.BMC Ophthalmology,2017,17(1):264.
［6］　HIRANO T,IESATO Y,TORIYAMA Y,et al.Detection of fovea-threatening diabetic macular edema by optical coherence tomography to maintain good vision by prophylactic treatment［J］.Ophthalmic Res,2014,52(2):65-73.
［7］　GROVER S,MURTHY R K,BRAR V S.Normative data for macular thickness by high-definition spectral-domain optical coherence tomography［J］.Am J Ophthalmol,2009,148(2):266-271.
［8］　IORGA R E,MORARU A,OZTURK M R.The role of optical coherence tomography in optic neuropathies［J］.Rom J Ophthalmol,2018,62(1):3-14.
［9］　WANG H,WU Y,CUI C,et al.Antifouling super water absorbent supramolecular polymer hydrogel as an artificial vitreous body［J］.Adv Sci,2018,5(11):1800711.
［10］　WINTER M,EBERHARDT W,SCHOLZ C.Failure of potassium siphoning by Müller cells:a new hypothesis of perfluorocarbon liquid-induced retinopathy［J］.Invest Ophthalmol Vis Sci,2000,41(1):256-261.
［11］　BALARATNASINGAM C,CHAE B,REMMER M H,et al.The spatial profile of macular pigments is related to the topological characteristics of the foveal avascular zone［J］.Invest Ophthalmol Vis Sci,2015,56(13):7859-7865.
［12］　OLMEDILLA-ALONSO B,ESTVEZ-SANTIAGO R,SILVN J M,et al.Effect of long-term xanthophyll and anthocyanin supplementation on lutein and zeaxanthin serum concentrations and macular pigment optical density in postmenopausal women［J］.Nutrients,2018,10(8):1-14.
［13］　RACZYNSKA D,MITROSZ K.The influence of silicone oil on the ganglion cell complex after pars plana vitrectomy for rhegmatogenous retinal detachment［J］.Curr Pharm Des,2018,24(29):3476-3493.
［14］　STANG M M,BARTZ-SCHMIDT K U.Incidence of revision ope-rations due to retinal(Re-)detachment following removal of the silicone oil tamponade with special emphasis on the time course［J］.Klin Monatsbl Augenheilkd,2018,12(5):246.

更新日期/Last Update: 2019-07-05