激光光凝或腔内激光联合玻璃体切除术治疗先天性视盘凹陷黄斑病变：光学相干断层扫描的“水坝征”是解剖成功的标志

Q4 Medicine

中华眼底病杂志 Pub Date : 2019-11-25 DOI:10.3760/CMA.J.ISSN.1005-1015.2019.06.012

Li Huang, C. Lyu, Jun Li

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The \"dam-sign\" change was a retinal choroidal scar on the channel between the ODP and the macula on the OCT image after treatment. The eyes were divided into a \"dam-sign\" change group (group A, 10 eyes) and no \"dam-sign\" change group (group B, 2 eyes). The BCVA of eyes in group A was 0.03-0.6. In group A, 1 eye was treated with laser photocoagulation alone, 9 eyes were treated with vitrectomy combined with laser photocoagulation. The BCVA of eyes in group B was 0.1. All the eyes in group B underwent vitrectomy combined with laser photocoagulation. The follow-up was ranged from 6 to 174 months. The same equipment and method before treatment were used for 1, 3, 6, 12, 18, and 24 months after treatment. The BCVA, absorption of subretinal fluid (SRF) and the formation of \"dam-sign\" change were observed. \n \n \nResults \nAt the last follow-up, the BCVA of eyes in group A was 0.4-1.0 (0.4 in 1 eye, 0.5 in 3 eyes, 0.6 in 2 eyes, 0.8 in 3 eyes, 1.0 in 1 eye). 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引用次数: 0

摘要

目的探讨激光光凝或激光联合玻璃体切除术治疗重度黄斑脱离型先天性视盘凹陷的成功征象。方法回顾性分析病例。本研究纳入2003 - 2018年中山眼科中心诊断的12例先天性ODP合并浆液性黄斑脱离患者的12只眼。男性2只(2眼)，女性8只(8眼)。平均年龄为30.17岁。所有眼均行视网膜激光光凝和/或玻璃体切除术。采用德国海德堡Spectralis OCT仪器跟踪模式对视盘和黄斑区进行扫描。在治疗后的OCT图像上，“坝征”改变为ODP和黄斑之间通道上的视网膜脉络膜疤痕。将眼睛分为“坝号”变化组(a组，10只眼)和无“坝号”变化组(B组，2只眼)。A组眼BCVA为0.03 ~ 0.6。A组单纯激光光凝治疗1眼，玻璃体切除联合激光光凝治疗9眼。B组眼BCVA为0.1。B组均行玻璃体切除联合激光光凝术。随访时间为6 ~ 174个月。治疗后1、3、6、12、18、24个月均采用治疗前相同的设备和方法。观察BCVA、视网膜下液(SRF)吸收及“坝征”形成改变。结果末次随访时，A组患者眼BCVA为0.4 ~ 1.0(1眼0.4,3眼0.5,2眼0.6,3眼0.8,1眼1.0)。玻璃体切除联合激光光凝治疗9眼，SRF完全吸收。单用激光光凝治疗1眼，SRF维持在少量。B组两眼BCVA分别为0.03、0.3;SRF在两者中都没有被吸收。结论激光光凝术后视盘附近“坝征”改变可促进SRF吸收，改善BCVA。可作为治疗后的成功指标。关键词:视盘/异常;激光凝固;玻璃体切除术;层析成像，光学相干;大坝标志改变

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Laser photocoagulation or endolaser combined with vitrectomy for congenital optic disc pit maculopathy: "dam sign" of optical coherence tomography is a sign to indicate the anatomic success

Objective To investigate the successful signs of laser photocoagulation or endolaser combined vitrectomy for congenital optic disc pit (ODP) with serous macular detachment. Methods A retrospective case analysis. Twelve eyes of 12 patients with congenital ODP complicated with serous macular detachment diagnosed in Zhongshan Ophthalmic Center from 2003 to 2018 were included in this study. There were 2 males (2 eyes) and 8 females (8 eyes). The average age was 30.17 years old. Retinal laser photocoagulation and/or vitrectomy were performed in all the eyes. The optic disc and macular area were scanned using the tracking mode of the Germany Heidelberg Spectralis OCT instrument. The "dam-sign" change was a retinal choroidal scar on the channel between the ODP and the macula on the OCT image after treatment. The eyes were divided into a "dam-sign" change group (group A, 10 eyes) and no "dam-sign" change group (group B, 2 eyes). The BCVA of eyes in group A was 0.03-0.6. In group A, 1 eye was treated with laser photocoagulation alone, 9 eyes were treated with vitrectomy combined with laser photocoagulation. The BCVA of eyes in group B was 0.1. All the eyes in group B underwent vitrectomy combined with laser photocoagulation. The follow-up was ranged from 6 to 174 months. The same equipment and method before treatment were used for 1, 3, 6, 12, 18, and 24 months after treatment. The BCVA, absorption of subretinal fluid (SRF) and the formation of "dam-sign" change were observed. Results At the last follow-up, the BCVA of eyes in group A was 0.4-1.0 (0.4 in 1 eye, 0.5 in 3 eyes, 0.6 in 2 eyes, 0.8 in 3 eyes, 1.0 in 1 eye). In 9 eyes treated with vitrectomy combined with laser photocoagulation, SRF was completely absorbed. In 1 eye treated with laser photocoagulation alone, SRF remained in small amount. The BCVA of the two eyes in group B was 0.03 and 0.3, respectively; and SRF was not absorbed in both of them. Conclusions The "dam-sign" change near optic disc after laser photocoagulation can promote SRF absorption and improve BCVA. It can be used as a success indicator after treatment. Key words: Optic disk/abnormalities; Laser coagulation; Vitrectomy; Tomography, optical coherence; Dam sign change

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来源期刊

中华眼底病杂志 Medicine-Ophthalmology

CiteScore

0.40

自引率

0.00%

发文量

5383

期刊介绍： Chinese Journal of Ocular Fundus Diseases is the only scientific journal in my country that focuses on reporting fundus diseases. Its purpose is to combine clinical and basic research, and to give equal importance to improvement and popularization. It comprehensively reflects the leading clinical and basic research results of fundus disease disciplines in my country; cultivates professional talents in fundus disease, promotes the development of fundus disease disciplines in my country; and promotes academic exchanges on fundus disease at home and abroad. The coverage includes clinical and basic research results of posterior segment diseases such as retina, uveal tract, vitreous body, visual pathway, and internal eye diseases related to systemic diseases. The readers are medical workers and researchers related to clinical and basic research of fundus diseases. According to the journal retrieval report of the Chinese Institute of Scientific and Technological Information, the comprehensive ranking impact factor and total citation frequency of the Chinese Journal of Ocular Fundus Diseases have been among the best in the disciplines of ophthalmology, otolaryngology, and ophthalmology in my country for many years. The papers published have been included in many important databases at home and abroad, such as Scopus, Peking University Core, and China Science Citation Database (CSCD).