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目的:观察波及黄斑区的孔源性视网膜离术后各时期黄斑区相干光断层扫描图像特征及孔源性视网膜脱离患者眼轴长度与手术后视网膜下液吸收的关系,分析其与视力恢复过程的相关性。方法:对53例(53眼)波及黄斑区的孔源性视网膜脱离经巩膜外加压术后视网膜复位的患者分别于术后1周、1月、3月、6月进行相干光断层扫描检查,观察黄斑区形态变化及黄斑区视网膜下液残留情况,并将检查结果与患者病程、眼轴长度以及手术后视力恢复情况等临床资料进行了对比分析。结果:术后1周,所有病例均残留程度不等的视网膜下液,随着时间的延长,积液不断吸收。与之相对应,患者视力逐渐提高。术后3月,黄斑区视网膜下积液全部吸收累计33例,其中眼轴长度大于26 mm患者视网膜下液吸收速度较慢,差异有统计学意义(P<0.05)。术后6月,43例患者黄斑区视网膜下积液全部吸收,仍有7例神经上皮浅脱离,3例局限性神经上皮脱离。术后6月时患者最佳矫正视力<0.05者7眼,0.05～0.3者17眼,≥0.3者29眼。结论:光学相断层扫描能从微观角度清晰地显示视网膜复位后黄斑区形态结构的变化。巩膜外加压术后视网膜复位的患者黄斑区仍残留少量的视网膜下积液,视网膜下积液的逐步吸收能较好地解释术后视力的恢复过程。眼轴长度大于26mm患者视网膜下液吸收速度较慢。
OBJECTIVE: To observe the features of macular coherence tomography images and the relationship between axial length of patients with rhegmatogenous retinal detachment and subretinal fluid absorption after macular hole-induced retinal detachment, analyze the relationship between them and visual acuity recovery Relevance. Methods: Fifty-three patients (53 eyes) with rhegmatogenous retinal detachment in macular area underwent retinal detachment after scleral buckling were examined by coherence tomography at 1 week, 1 month, 3 months and 6 months after operation , Observed macular morphological changes and macular subretinal fluid residue, and the results of the examination and patient duration, axial length and visual acuity after surgery and other clinical data were compared and analyzed. Results: One week after operation, residual subretinal fluid of varying degrees remained in all cases. As the time prolonged, the fluid continuously absorbed. Correspondingly, patients gradually improve visual acuity. Subsequent to March, macular subretinal fluid accumulated in all 33 cases, of which axial length greater than 26 mm subretinal fluid absorption rate is slower, the difference was statistically significant (P <0.05). After 6 months, 43 cases of macular subretinal fluid were completely absorbed, there are still 7 cases of neuroepithelial detachment, 3 cases of localized nerve epithelium detachment. After 6 months, the best corrected visual acuity was <0.05 in 7 eyes, 0.05 ~ 0.3 in 17 eyes, and ≥ 0.3 in 29 eyes. Conclusions: Optical phase tomography can clearly show the morphological changes of the macula after retinal reattachment from the microscopic point of view. Retinal remodeling after scleral buckling in patients with macular retinal remnants still remain a small amount of fluid, the gradual absorption of subretinal fluid can better explain the postoperative recovery of visual acuity. Subretinal fluid is absorbed more slowly in patients with an axial length greater than 26 mm.