摘要
目的 探讨视网膜分支静脉阻塞（BRVO）伴黄斑囊样水肿患者的光感受器细胞层变化与视力之间的关系.方法 回顾性病例系列研究.对2008年1月至2010年1月就诊的41例（41只眼）BRVO伴黄斑囊样水肿患者的临床资料进行回顾性分析.纳入对象均采用频域相干光断层扫描（OCT）仪测量黄斑中心凹神经上皮层厚度、中心凹囊腔下光感受器细胞层厚度、中心凹水肿囊腔的高度与水平宽度.根据患者光感受器细胞内外节（IS-OS）层的检测情况,分为3组进行分析,完全连续组8例,不完全连续组19例,完全缺失组14例.采用Spearman相关检验法分析各项检测参数与视力的相关性,应用LSD检验法比较不同IS-OS组间患者logMAR视力差异.结果 41例（41只眼）BRVO黄斑囊样水肿患者黄斑中心凹神经上皮层厚度平均（484.71±131.86）μm,光感受器细胞层厚度平均（92.04±45.53）μm,中心凹囊腔面积平均772.59 μm×362.17 μm.经Spearman相关性检验,上述检测参数中仅光感受器细胞层厚度与logMAR视力相关（r=-0.373,P=0.016）.IS-OS层完全缺失组患者的logMAR视力与完全连续组和不完全连续组间差异均有统计学意义（P=0.030,0.003）,而完全连续组与不完全连续组间差异无统计学意义（P=0.750）.结论 BRVO伴黄斑囊样水肿患者的视力随白身光感受器细胞层厚度的增加而提高,IS-OS层完全缺失的患者较存在IS-OS层的患者视力差.
Objective To study the correlation of visual acuity and photoreceptor in eyes with persistent cystoid macular edema associated with branch retinal vein occlusion （BRVO）. Methods It was a retrospective case series study. Medical records of 41 patients （ 41 eyes ） with persistent cystoid macular edema secondary to BRVO diagnosed in Department of Ophthalmology, Peking Union Medical College Hospital from January 2008 to January 2010 were studied retrospectively. On the images obtained by spectral-domain OCT, the thickness of foveal neurosensory retina and photoreceptor layer that was beneath the foveal cystoid spaces, and the transverse length and height of foveal cystoid spaces were measured. The status of the junction between inner and outer segments of the photoreceptors （IS-OS） in the fovea was also assessed. The correlations between the parameters above and visual acuity were analyzed. Results The average foveal neurosensory thickness was （ 484.71 ± 131.86） μm, the photoreceptor layer thickness was （92.04 ： 45. 53 ） μm and the size of foveal cavity was 772.59 μm ×362.17 μm. By the Spearman＇s rank correlation analysis, among the parameters above, only photoreceptor layer thickness showed correlation with logMAR visual acuity （r = -0. 373, P = 0. 016 ）, while other parameters showed no correlation with logMAR visual acuity. Cases were classified as three groups according to the status of IS-OS layer：continuous group（8 cases）, discontinuous group（ 19 cases） and interrupted group（ 14 cases）. LogMAR visual acuity in these eyes with an interrupted IS-OS line in the fovea was significantly worse than that in eyes with a continuous or discontinuous IS-OS line （ P = 0. 030 and 0. 003, respectively）. There was no statistical difference between continuous and discontinuous group （ P = 0. 750 ）. Conclusions In patients with persistent cystoid macular edema associated with BRVO, the thickness of the foveal photoreceptor layer are positively associated with visual acuity, and the eyes without IS-OS layer have worse visual acuity than eyes with IS-OS layer.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2010年第11期1006-1010,共5页
Chinese Journal of Ophthalmology
