【摘要】 目的　了解光相干断层扫描 (optical coherence tomography,OCT)对检测巩膜扣带术后黄斑形态改变及与视功能的意义。　方法　应用 Zeiss- Humphrey OCT检查仪对 6 8例 (70只眼 )巩膜扣带术复位成功的患者黄斑区进行经中心凹水平、垂直扫描 ,观察黄斑形态。　结果　 70只受检眼中 ,黄斑区结构正常 2 2只眼 ,神经上皮平均厚度为 (146 .47± 2 0 .5 9) μm,黄斑结构异常 48只眼 ,检测异常率为 6 8.6 % ,其中黄斑区视网膜神经上皮下较多残液“间隙”存留 19只眼 ,局限性残液存留 9只眼 ;黄斑区视网膜水肿 8只眼 ,神经上皮变薄 4只眼 ,黄斑区、后极部视网膜下增生 4只眼 ,黄斑、后极部视网膜前膜 4只眼。OCT黄斑结构正常组 ,手术后 2周视力≥ 0 .3者 :6只眼 ,3个月时有 14只眼 ;黄斑水肿组 8只眼 ,手术后 2周视力≥0 .3者 :1只眼 ,3个月时有 2只眼 ;视网膜神经上皮下残存液体 ,手术后 2周视力≥ 0 .3者 5只眼 ,3个月时有 2 3只眼 ,说明巩膜扣带术后的黄斑结构变化与手术后视功能存在一定关系。随访 3个月时 ,黄斑正常组、神经上皮脱离组和其它病变组视力在 0 .3以上所占的比例差异有显著性的意义 (χ2 =18.91,P<0 .0 1)。　结论　OCT能精确地探查视网膜复位术后黄斑结构的变化 ,并且能较好地解释患眼视功能变更多还原

【Abstract】 Objective To verify the significance of the morphological changes of the macula and its relationship to visual function by using optical coherence tomography (OCT) after scleral buckling procdure. Methods The macula of retinae of 68 patients (70 eyes) with reattached retinae after scleral buckling operation for retinal detachment were examined by OCT to scan the macula through fovea vertically and horizontally. Results Among the 70 eyes, 22 eyes revealed normal macula with thickness of neurosensory retina meant (146.47±20.59) μm. In the other 48 eyes (68.60%) with abnormal macula, 19 eyes showed extensive subretinal interspace, 9 eyes showed local subretinal interspace, 8 eyes showed macula edema, 4 eyes showed thin macula, 4 eyes showed subretinal proliferation and 4 eye showed epiretinal membrane over macula. In the normal macular structure group under the OCT, the visual acuity (VA) of the operated eyes was more than 0.3 in 6 eyes 2 weeks after operation and in 14 eyes 3 mons after operation. In the macula edema group, the VA was more than 0.3 in 1 eye 2 weeks after opoeration and 2 eyes 3 mons after operation. In the subretinal interspace group, the VA was more than 0.3 in 5 eyes 2 weeks after operation and in 23 eyes 3 mons after operation. The proportions of the numbers of operated eyes with the VA more than 0.3 after 3 mons of the operation in macular normal group subretinal interspace group and other macular disease group were significantly different (χ 2=18.91, P<0 01). Conclusion OCT can precisely detect the structural changes of macula after retinal reattachment and assess visual function after surgery of retinal detachment.更多还原