目的 比较巩膜扣带术和玻璃体切除术两种术式对孔源性视网膜脱离患者视网膜复位率、血清氨基酸与血管内皮生长因子(VEGF)变化.方法 回顾性分析我院以孔源性视网膜脱离为第一诊断的病例资料60例(60只眼),依据术式分为两组,A巩膜扣带术组,B玻璃体切除术组.记录两组术前和术后不同时间点手术复位率、血清中氨基酸表达水平及VEGF等变化情况.结果 应用相干光层析成像术(OCT)记录视网膜复位情况:术后1周A组神经上皮下积液15例,B组5例;术后1个月A组10例,B组0例;术后3个月A组2例,B组0例;最佳矫正视力(BCVA)两组患者复位术后均较术前明显提高,有统计学差异(P<0.05),两组间比较,患者术后各时间点的BCVA差异无统计学意义(均P>0.05);术后1周,两组患者血清中谷氨酸、苯丙氨酸、组氨酸及VEGF水平较术前均显著降低,差异有统计学意义(P<0.05),与巩膜扣带术比较,玻璃体切除术组中谷氨酸、苯丙氨酸、组氨酸及VEGF水平降低,差异有统计学意义(P<0.05).结论 玻璃体切除术能够早期降低谷氨酸、苯丙氨酸、组氨酸及VEGF水平及视网膜复位率增加手术安全性,提高患者满意度,相较于巩膜扣带术更具有优越性.

Objective:To investigate the changes of FAZ, BCVA and F-ERG after RRD.Methods:A retrospective analysis was performed on 40 cases of 40 eyes with RRD as the first diagnosis in our hospital. The data of BCVA, FAZ and F-ERG were recorded at different time points after operation.Results:the blood flow density of the SCP and DCP in the total 3 mm×3 mm area was higher in both groups 6 months after the operation( P=0.001).Partial correlation analysis showed that the change of FAZ area was negatively correlated with the BCVA( r =-0.215, P =0.014).Six months after surgery, the amplitude of F-ERG in group B was lower than that in group A, and the peak time was longer than that in group A, ( P < 0.05). Conclusion:PPV is superior to SB in the recovery of RRD patients with macular retinal blood flow density and visual function.

探讨黄斑部视网膜血流密度变化以及(The best corrected visual acuity) BCVA(最佳矫正视力)在孔源性视网膜脱离(Rhegmatogenous retinal detachment,RRD)两种术式后的对比研究.回顾性分析我院以孔源性视网膜脱离为第一诊断的病例资料40例40眼,依据术式分为2组,A巩膜扣带术组,B玻璃体切除术组.记录术后2w、1、3、6个月BCVA、黄斑部视网膜血流密度等检查资料.结果 显示两组患者总3 mm×3 mm区域浅层及深层毛细血管丛血流密度在术后6个月均较高(均P=O.001).偏相关分析显示,患者的FAZ面积的变化与最佳矫正视力呈负相关性(r=-0.215,P=0.014).玻璃体切除术对RRD患者黄斑部视网膜血流密度的恢复优于巩膜扣带术.应用OCTA检查随访RRD患者术后黄斑区血流密度变化,对于评估黄斑部视网膜结构和功能的变化有重要意义.但选择哪种手术方式,仍需要大样本研究及长期随访进行评估.

AIM:To evaluate the changes of macular retinal vessel density after the first intravitreal anti-vascular endothelial growth factor(VEGF)injection for macular edema secondary to retinal vein occlusion. METHODS: A retrospective case control series, 23 cases with RVO secondary macular edema were included from April 2018 to July 2018. They were treated with 0.5mg/0.05mL intravitreal injection of conbercept. To compare the best corrected visual acuity(BCVA)before and after treatment. Optical coherence tomography angiography(OCTA)images was obtained, central macular thickness(CMT)and vessel length density and perfusion density in the superficial retinal capillary plexus were measured before and after intravitreal injection.RESULTS: The mean interval between baseline and follow up was 1mo. The improvement of BCVA, the decreased value of average central macular thickness after treatment were better than before(P<0.05). The vessel length density and perfusion density at the central, inner and full region in the superficial retinal capillary plexus was not significantly different after intravitreal injection(P>0.05).CONCLUSION: The average BCVA and the mean CMT of patients with RVO secondary macular edema after treatment was significantly better, and it is not progressive macular ischemia in the short-term after a single intravitreal injection of an anti-VEGF agent.