三维平视显示系统与术中光学相干断层扫描辅助玻璃体切除术相结合治疗近视中央凹裂

Q4 Medicine

中华眼底病杂志 Pub Date : 2019-11-25 DOI:10.3760/CMA.J.ISSN.1005-1015.2019.06.002

Chun Zhang, Xiuju Chen, Mingwei Liu, Xiangdong Luo

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引用次数: 0

摘要

目的观察数字3D平视显示系统（3D viewing system）和术中OCT（iOCT）在玻璃体切除术治疗近视中央凹裂（MF）中的临床疗效。方法回顾性、连续性病例系列。2018年10月至2019年5月，在厦门大学厦门眼科中心连续19例MF患者中的19只眼接受了玻璃体切除术。男7例，女12例，平均年龄54.47±11.38岁。平均轴长为30.40±2.30mm，平均logMAR BCVA为0.56±0.31，平均中央凹厚度（CFT）为317.80±151.9.32μm，平均最大视网膜厚度（maxRT）为556.7±143.7μm。所有的手术都是结合iOCT的3D观察系统进行的。标准的25G pars平面玻璃体切除术是通过去除后玻璃体和内界膜（ILM）的吲哚青绿（ICG）染色以及空气-液体交换进行的。19只眼睛中有13只接受了保留中央凹的ILM剥离，其余6只没有。平均随访4.2±1.4个月。所有患者都进行了定期随访，以记录BCVA的变化、黄斑、CFT和maxRT的解剖变化。配对t检验用于比较术前和术后BCVA、CFT和maxRT。结果所有眼均能在三维视觉系统上清晰显示黄斑的精细图像。电子绿色滤光片增强了ICG染色图像的对比敏感度。所有眼睛的黄斑均通过iOCT获得清晰的图像。平均手术时间为35.5±8.2分钟。在最后一次随访中，19眼MF中有16眼消退。平均CFT为178.5±103.5μm，最大RT为341.8±83.8.16μm，平均logMAR BCVA为0.35±0.22。术前和术后CFT、maxRT和logMAR BCVA差异有统计学意义（t=4.181，7.154，5.129；P<0.001）。没有与3D观看系统相关的并发症。结论在病理性近视患者中，三维视觉系统可提高ICG的对比度和黄斑图像染色的清晰度。iOCT可以在手术中检测到最小的不可见全厚度黄斑裂孔。两者都可能有助于提高MF闭合率和BCVA。关键词：玻璃体视网膜手术/器械；层析成像、光学相干；视网膜裂/手术；肌退行性变/并发症；3D平视显示查看系统

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Combining 3D heads-up display viewing system and intraoperative optical coherence tomography-assisted vitrectomy for myopic foveoschisis

Objective To observe the clinical efficacy of digital 3D heads-up display viewing system(3D viewing system) and intraoperative OCT (iOCT) in vitrectomy for myopic foveoschisis (MF). Methods A retrospective, consecutive case series. From October 2018 to May 2019, Nineteen eyes of 19 consecutive patients with MF diagnosed in Xiamen Eye Center of Xiamen University who underwent vitrectomy were included in this study. There were 7 males and 12 females, with the mean age of 54.47±11.38 years. The average axial length was 30.40±2.30 mm, the mean logMAR BCVA was 0.56±0.31, the mean central foveal thickness (CFT) was 317.80±151.9.32 μm, the mean max retinal thickness (maxRT) was 556.7±143.7 μm. All the surgeries performed combined with 3D viewing system with iOCT. The standard 25G pars planar vitrectomy were performed with removing the posterior vitreous and indocyanine green (ICG) staining of internal limiting membrane (ILM) and air-fluid exchange. Thirteen of 19 eyes underwent fovea-sparing ILM peeling and the other 6 eyes not. The average follow-up was 4.2±1.4 months. All the patients were on regular follow-up to document the changes on BCVA, anatomical changes in macula, CFT and maxRT. Paired t test was used to compare BCVA, CFT and maxRT before and after surgery. Results The fine images of macula were clearly shown on the 3D viewing system in all eyes. The electronic green filter enhanced the contrast sensitivity of ICG stained images. Clear images of macula were captured by iOCT in all eyes. The average surgical time was 35.5±8.2 min. On the last follow-up, 16 of 19 eyes with MF resolved. The mean CFT was 178.5±103.5 μm, the maxRT was 341.8±83.8.16 μm, and the mean logMAR BCVA was 0.35±0.22. The differences of CFT, maxRT and logMAR BCVA before and after surgery were statistically significant (t=4.181, 7.154, 5.129; P<0.001). Minimal invisible full thickness macular hole were detected in 2 eyes by iOCT and repaired with auto serum or ILM flap covering. There was no complication associated with the 3D viewing system. Conclusions 3D viewing system provides improved contrast and crystal clear macular image stain with ICG in pathological myopia. iOCT can detect the minimal invisible full thickness macular hole during surgery. Both may contribute to improved MF closure rate and BCVA. Key words: Vitreoretinal surgery/instrumentation; Tomography, optical coherence; Retinoschisis/surgery; Myopiadegenerative/complications; 3D heads-up display viewing system

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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).