| Objective: To observe the changes of capillary blood flow density and nerve fiber thickness of optic disc filled with silicone oil by optical coherence tomography angiography (OCTA).Methods: a total of 32 patients with rhegmatogenous retinal detachment who underwent vitrectomy,retinal detachment reduction and silicone oil filling in our hospital from January to October 2018 were selected as research objects.At the same time,32 healthy subjects were selected as the control group.Organize the basic information of patients,including name,gender,age,onset time,previous systemic disease history,drug treatment history,laser treatment history,family genetic disease history,work status,etc.All the selected patients underwent detailed eye examination before surgery,mainly using the international standard visual acuity chart to check the naked eye vision,and the patients wearing glasses to check the wearing glasses vision;Non-contact tonometer was used to measure the iop of the affected eye.After the pupil was dilated,the fundus was examined by slit lamp microscope combined with 90 D front mirror,and the retinal and optic nerves of the fundus were observed.All the retinas were restored postoperatively.Postoperative follow-up was conducted for 6 months.OCTA examined the optic disc capillary blood flow density and nerve fiber layer thickness of 1w,1m,3m and 6m before and after silicone oil filling,and performed statistical analysis.Results: the selected patients were followed up and their visual acuity was measured by international standard visual acuity chart.It was suggested that 10 of the 32 subjects had the best corrected visual acuity <0.05,18 had the best corrected visual acuity between 0.05 and 0.2,and 4 had the best corrected visual acuity over 0.2.All the selected patients had improved vision after surgery.The visual acuity of the selected patients was measured one week after the operation,indicating that the visual acuity was higher than that before the operation.2 to 3 months after the operation,the visual acuity of the patients was improved compared with 1 week after the operation,and the visual acuity of the patients was significantly improved with the extension of time.Among the 32 patients selected 2 to 3 months after the operation,12 cases had the best corrected visual acuity over 0.2,and 15 cases had the best corrected visual acuity between 0.05 and 0.2,which was significantly better than that before treatment.In 5 patients with intraoperative cataract extraction and intraocular lens implantation at the same time of silicone oil extraction,the visual acuity was improved to varying degrees.The changes of capillary blood flow density of optic nerve in the selected patients before and after surgery and before and after removal of silicone oil were not significant,suggesting that silicone oil filling (in the absence of obvious emulsification state) had little effect on capillary blood flow of optic disc.The iop of 32 patients was between 9-24 mmhg 1 month,3 months and 6 months after the operation,and the iop was stable.The non-emulsified silicone oil filling had no effect on the intraocular pressure of the patients.The thickness of optic nerve fiber layer decreased (p<0.05).There were 2 cases with a small amount of silicone oil emulsification,1 case occurred 3 months after the operation,and 1 case occurred 6 months after the operation.After taking out the silicone oil,it was found that the emulsified silicone oil particles were in the shape of dust,suggesting that the emulsification was caused by the change of silicone oil properties.Conclusion: Silicone oil filling without obvious emulsification within 3-6 months has little effect on the capillary blood flow of optic disc,but can reduce the thickness of optic nerve fibers to some extent. |
PDF Full Text Request