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目的 探讨黄斑部手术后解剖结构改变的客观评价方法。 方法 对 31例 (31只眼 )各种黄斑病变 ,包括黄斑裂孔 (idiopathic macular hole,IMH) 15只眼 ,单纯黄斑前膜 (epiretinal membranes ,ERMs) 8只眼 ,老年黄斑变性 (age related macular degeneration,AMD) 4只眼 ,特发性黄斑下新生血管膜4只眼。术前术后进行眼底检查、眼底照相、荧光素眼底血管造影 (fundus fluorescein angiography ,FFA)以及光学相干断层成像术检查 (optical coherence tomography,OCT) ,将各种检查结果进行比较及评价。 结果 眼底检查、照相显示所有黄斑裂孔封闭 ,但 OCT发现 2例未完全闭合 ,1例黄斑区神经上皮变薄 ;FFA发现 5例视网膜色素上皮 (retinal pigment epithelium,RPE)缺损。对于 ERM、黄斑下新生血管膜 ,检眼镜检查难确定是否已完全清除 ,FFA显示新生血管膜消失及不同程度的 RPE损害 ;OCT能清楚显示 ERM、新生血管膜消失 ,3例同时见神经上皮层变薄。 结论 常规的各种眼底检查可在一定程度上对黄斑疾患手术后的解剖结构进行评价 ,OCT则能清楚、精确地显示黄斑部的各种病变 ,尤其对手术后黄斑部各种组织结构的改变能更精确、更全面地进行评价。
Objective To evaluate the objective evaluation of anatomical changes after macular surgery. Methods Thirty - one patients (31 eyes) with various macular degeneration, including 15 eyes with idiopathic macular hole (IMH), 8 eyes with simple epiretinal membranes (ERMs), age - related macular degeneration , AMD) 4 eyes, idiopathic macular neovascular membrane 4 eyes. Fundus examination, fundus photography, fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were performed before and after surgery, and the results of various examinations were compared and evaluated. Results The fundus examination showed that all the macular holes were closed. However, OCT showed that the two cases were not completely closed and one case of macular nerve thinning. FFA found five cases of retinal pigment epithelium (RPE) defect. For ERM, under the macular neovascularization, ophthalmoscopy is difficult to determine whether the complete removal of the FFA showed neovascularization disappear and varying degrees of damage to the RPE; OCT can clearly show the ERM, neovascular disappeared, 3 cases also see the neural epithelium Thinning. Conclusion Conventional fundus examination can evaluate the postoperative anatomy of macular degeneration to a certain extent. OCT can clearly and accurately show various macular lesions, especially the changes of various histological structures of the macula after operation Can be more accurate and more comprehensive evaluation.