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[1]高 翔,陈 松,何广辉,等.内界膜剥除联合空气填充治疗中大直径特发性黄斑裂孔的临床观察[J].天津医科大学学报,2019,25(05):516-519.
 GAO Xiang,CHEN Song,HE Guang-hui,et al.Clinical observation of medium and large diameter idiopathic macular hole in the treatment of internal limiting membrane stripping combined with air filling[J].Journal of Tianjin Medical University,2019,25(05):516-519.
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内界膜剥除联合空气填充治疗中大直径特发性黄斑裂孔的临床观察(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
25
期数:
2019年05期
页码:
516-519
栏目:
临床医学
出版日期:
2019-09-20

文章信息/Info

Title:
Clinical observation of medium and large diameter idiopathic macular hole in the treatment of internal limiting membrane stripping combined with air filling
文章编号:
1006-8147(2019)05-0516-04
作者:
高 翔陈 松何广辉王俊华武 斌王 健马映雪田 歌孟硕硕
(天津医科大学眼科临床学院,天津市眼科医院玻璃体视网膜疾病治疗科,天津市眼科学与视觉科学重点实验室, 天津市眼科研究所,天津300020)
Author(s):
GAO XiangCHEN SongHE Guang-hui WANG Jun-hua WU BinWANG JianMA Ying-xueTIAN Ge MENG Shuo-shuo
(Clinical College of Ophthalmology, Tianjin Medical University, Vitreoretinal Therapy Center, Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin 300020,China)
关键词:
内界膜剥除特发性黄斑裂孔空气
Keywords:
internal limiting membrane stripping idiopathic macular hole medium and large diameter macular hole
分类号:
R774.5
DOI:
-
文献标志码:
A
摘要:
目的:观察内界膜剥除联合空气填充治疗直径在250~600 μm之间的特发性黄斑裂孔(IMH)临床疗效。方法:临床确诊为IMH并经过OCT测量黄斑裂孔最小直径在250~600 μm之间的患者45例45只眼纳入研究,按照黄斑裂孔直径并将其分为中直径(250~400 μm)裂孔组(M组)25例及大直径(401~600 μm)裂孔组(L组)20例。两组患者术前均行眼压,裂隙灯显微镜,眼轴测量,双目间接检眼镜及OCT测量黄斑裂孔直径,观察术后两组黄斑孔闭合及BCVA情况。结果:手术后随访时间1~24个月,其平均随访时间为(12.5±6.1)个月。(1)黄斑裂孔闭合率M组与L组分别为100%和95%,差异无统计学意义(t=3.265,P=0.066)。(2)M、L组患眼平均logMAR BCVA分别为0.33±0.27、1.18±0.34。与手术前平均logMAR BCVA比较,M组患眼logMAR BCVA差异有统计学意义(t=2.786,P=0.016);(3)L组患眼术前术后logMAR BCVA差异无统计学意义(t=1.786,P=0.124)。结论:剥除内界膜联合空气填充治疗直径在250~600 μm之间IMH闭合率高,对于250~400 μm之间IMH患者术后视力改善明显;对于401~600 μm之间的IMH,患者术后视力改善效果不理想。
Abstract:
Objective: To observe the clinical efficacy of internal limiting membrane stripping combined with air filling on a postsurgical idiopathic macular hole with a diameter of 250~600 μm. Methods: A total of 45 eyes of 45 patients with IMH whose macular hole were between 250~600 μm in diameter were included. Patients were divided into the middle diameter (250~400 μm) hole group(M group, 25 eyes)and large diameter (401~600 μm) hole group (L group,20 eyes). Intraoperative pressure, slit lamp microscope, axial measurement, binocular indirect ophthalmoscope and OCT were used to measure the preoperative and postoperative macular hole diameters, closure ratio and BCVA. Results: Minimum followed-up time was 1 month[average (12.5±6.1) months,1~24 months] (1) The macular hole closure rate were 100% and 95% in group M and group L, and there was no significant difference between two groups(t=3.265, P=0.066).(2) The average logMAR BCVA in the M and L groups were 0.33±0.27 and 1.18±0.34. Compared with the preoperative mean logMAR BCVA in group M, there was statistically significant difference(t=2.786, P=0.016). (3)There was no significant difference betweenpreoperative and postoperative logMAR BCVA in group L(t=1.786, P=0.124). Conclusion: The method of stripping the inner limiting membrane filling combined with air filling has a high closure rate of IMH between 250~600 μm. The BCVA is improved significantly in the group of 250~400 μm. No significant improvement of postoperative BCVA has been observed in the group of 401~600 μm.

参考文献/References:

[1] Kelly N E, Wendel R T. Vitreous surgery for idiopathic macular holes. Results of a pilot study[J]. Arch Ophthalmol, 1991, 109(5): 654
[2] Brooks H L. Macular hole surgery with and without internal limiting membrane peeling[J]. Ophthalmology, 2000, 107(10): 1939
[3] Christensen U C, Kr?覬yer K, Sander B, et al. Value of internal limiting membrane peeling in surgery for idiopathic macular hole stage 2 and 3: a randomised clinical trial[J]. Br J Ophthalmol, 2009, 93(8): 1005
[4] Lois N, Burr J, Norrie J, et al. Internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole: a pragmatic randomized controlled trial[J]. Invest Ophthalmol Vis Sci, 2011, 52(3): 1586
[5] Holladay J T. Proper method for calculating average visual acuity[J]. J Refract Surg, 1997, 13(4): 388
[6] Duker J S, Kaiser P K, Binder S, et al. The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole[J]. Ophthalmology, 2013, 120(12): 2611
[7] Gass J D. Reappraisal of biomicroscopic classification of stages of development of a macular hole[J]. Am J Ophthalmol, 1995, 119(6): 752
[8] Mester V, Kuhn F. Internal limiting membrane removal in the management of full-thickness macular holes[J]. Am J Ophthalmol, 2000, 129(6): 769
[9] Spiteri C K, Lois N, Scott N W, et al. Vitrectomy with internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole[J]. Ophthalmology, 2014, 121(3): 649
[10] Abdelkader E, Lois N. Internal limiting membrane peeling in vitreo-retinal surgery[J]. Surv Ophthalmol, 2008, 53(4): 368
[11] Tadayoni R, Paques M, Massin P, et al. Dissociated optic nerve fiber layer appearance of the fundus after idiopathic epiretinal membrane removal[J]. Ophthalmology, 2001, 108(12): 2279
[12] Ito Y, Terasaki H, Takahashi A, et al. Dissociated optic nerve fiber layer appearance after internal limiting membrane peeling for idiopathic macular holes[J]. Ophthalmology, 2005, 112(8): 1415
[13] Haritoglou C, Gass C A, Schaumberger M, et al. Macular changes after peeling of the internal limiting membrane in macular hole surgery[J]. Am J Ophthalmol, 2001, 132(3): 363
[14] Tadayoni R, Svorenova I, Erginay A, et al. Decreased retinal sensitivity after internal limiting membrane peeling for macular hole surgery[J]. Br J Ophthalmol, 2012, 96(12): 1513
[15] Ohta K, Sato A, Senda N, Fukui E. Comparisons of foveal thickness and slope after macular hole surgery with and without internal limiting membrane peeling[J]. Clin Ophthalmol,2018, 12: 503
[16] Christensen U C. Value of internal limiting membrane peeling in surgery for idiopathic macular hole and the correlation between function and retinal morphology[J]. Acta Ophthalmol, 2009, 87 Thesis 2:1
[17] Almony A, Nudleman E, Shah G K, et al. Techniques, rationale, and outcomes of internal limiting membrane peeling[J]. Retina, 2012, 32(5): 877
[18] Uemoto R, Yamamoto S, Takeuchi S. Epimacular proliferative response following internal limiting membrane peeling for idiopathic macular holes[J]. Graefes Arch Clin Exp Ophthalmol, 2004, 242(2): 177
[19] Hasegawa Y, Hata Y, Mochizuki Y, et al. Equivalent tamponade by room air as compared with SF(6) after macular hole surgery[J]. Graefes Arch Clin Exp Ophthalmol, 2009, 247(11): 1455
[20] 贺峰, 郑霖, 董方田. 特发性全层

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备注/Memo

备注/Memo:
作者简介 高翔(1992-),男,硕士在读,研究方向:眼底病;通信作者:陈松,E-mail:chensong9999@126.com。
更新日期/Last Update: 2019-10-11