| Objective:1 To observe the image characteristics and the regularity of blue light fundus autofluorescence(BL-FAF,excitation light is 488 nm, filter >500 nm) and near—infrared fundus autof1uorescence(NIR-FAF,excitation light is 787 nm, filter > 800 nm) after the idiopathic macular hole vitrectomy, indocyanine green assisted ILM peer off with 12% C3F8 intraocular filling.2 To provide the basis of the clinical prognosis assessment by reseaching the correlation analysis between the FAF image and the visual function, the the macular area retinal microstructure changes, closed form, by application of confocal scanning laser ophthalmoscope combined spectral-domain optical coherence tomography.Methods:1 Study objects: This study collected 116 eyes of 114 subjects with idiopathic macular hole from February 2012 to December 2015 at the second hospital of hebei medical university eye centre treatment. All patients had the vitrectomy, indocyanine green assisted ILM peer off with gas filling operation. Regular follow-up NIR-FAF is 33 eyes, regular follow-up BL-FAF is 71 eyes.2 Study content: Preoperative ocular examination including best-corrected visual acuity(BCVA), intraocular pressure(IOP), slit lamp microscope, binocular indirect ophthalmoscope, SD-OCT, recorded the preoperative macular hole diameter.Postoperative ocular examination including BCVA, intraocular pressure, SD-OCT, fundus camera, BL-FAF and NIR-FAF examination, recorded the BCVA, IS/OS defect diameter, ELM defect diameter, BL-FAF images,NIR-FAF images and the closed form of macular hole. Analysing a certain relationship between of the data.Results: 1 BL-FAF 1.1 Incidence of postoperative BL-FAF: Postoperative 1, 3, 6 months incidence were 49.30%, 76.06%,78.87%.Through statistical analysis, think that there is statistical difference between the overall(P = 0.000 < 0.05), comparing the two results shows that postoperative 1 month and 3 months are statistically significant, postoperative 1 month and 6 months are statistically significant and postoperative 3 months has no statistical differences with postoperative 6 months. 1.2 BL-FAF incidence compared with preoperative macular hole diameter: BL-FAF incidence of postoperative 1, 3 and 6 months macular hole diameter is greater than or equal to 500 groups were 62.50%, 81.25% and 84.38%. Postoperative 1, 3 and 6 months macular hole diameter less than 500 group incidence were 38.46%,71.79% and 74.36. By the statistical test, the two groups of the postoperative 1 month have statistical difference(P=0.044<0.05); the two groups of the postoperative 3, 6 months has no significant statistical difference(P3=0.353>0.05 P6=0.304>0.05). With the extension of time, the two groups BL-FAF incidence had no significant difference. 1.3 BL-FAF and BCVA: Postoperative 1 month LogMAR and BL-FAF image exist positive correlation(r=0.320, P=0.006<0.05), that is to say, postoperative 1 month BCVA and BL-FAF image exist negative correlation relationship; postoperative 3, 6 months LogMAR and BL-FAF image do not exist correlation(r3=0.227, P3= 0.057>0.05; r6=0.191, P6=0.111>0.05), that is to say,postoperative 3 and 6 months BCVA and BL-FAF image do not exist correlation. 1.4 BL-FAF and macular central foveal thickness: Postoperative 1, 3 and 6 months macular central foveal thickness and BL-FAF image exist negative correlation(r1=-0.465, P1=0.000<0.05; r3=-0.464, P3=0.000<0.05; r6=-0.409, P6=0.000<0.05). 1.5 BL-FAF and ELM defect diameter: Postoperative 1 month ELM delfect diameter and BL-FAF image exist positive correlation(r=0.379, P=0.001<0.05); postoperative 3 and 6 months ELM defect diameter and BL-FAF image do not exist correlation(r3=0.082,P3=0.498>0.05; r6=0.119, P6=0.097>0.05). 1.6 BL-FAF and IS/OS defect diameter: Postoperative 1 month IS/OS defect diameter and BL-FAF image exist positive correlation(r=0.252, P=0.034<0.05; postoperative 3 and 6 months IS/OS defect diameter and BL-FAF image do not exist correlation(r3= 0.122, P=0.312>0.05; r6=0.081, P6=0.259>0.05). 1.7 BL-FAF and patterns of macular hole closure: Postoperative 1, 3, 6 months patterns of macular hole closure and BL-FAF do not exist correlation(r1=-0.090, P1=0.456>0.05; r3=0.159, P3=0.185>0.05; r6=0.205, P6=0.086> 0.05). 2 NIR-FAF 2.1 Incidence of postoperative NIR-FAF : Postoperative 1, 3, 6 months were 75.76%, 78.79%, 81.82%, Through statistical analysis, think that there is no statistical difference between the overall(P=0.834>0.05). 2.2 NIR-FAF and BCVA: Postoperative 1,3 and 6 months LogMAR and NIR-FAF image do not exist correlation,that is to say, postoperative 1, 3 and 6 months BCVA and NIR-FAF image do not exist correlation(r=0.299, P1=0.091>0.05; =0.189, P3=0.292>0.05; r6=0.088, P6=0.627>0.05). 2.3 NIR-FAF and ELM defect diameter: Postoperative 1 month ELM defect diameter and NIR-FAF image exist positive correlation(r=0.460, P=0.007<0.05); postoperative 3 and 6 months ELM defect diameter and NIR-FAF image do not exist correlation(r3=0.335, P3=0.057>0.05; r6=0.284, P6=0.109>0.05). 2.4 NIR-FAF and IS/OS defect diameter: Postoperative 1 month IS/OS defect diameter and NIR-FAF image exist positive correlation(r=0.371, P=0.033<0.05; postoperative 3 and 6 months IS/OS defect diameter and NIR-FAF image do not exist correlation(r3 = 0.004, P3=0.983>0.05; r6 =0.224, P6=0.210>0.05). 2.5 Postoperative image characteristics of NIR-FAF: Central fovea of macular showing point shape strong fluorescence(incidence is 75%); macular subfoveal showing a approximate circular low fluorescence or no fluorescent area, the area radius is about 1.5 PD, and as time goes on, the region boundary clearerly(incidence is 54%); optic disk showing strong fluorescence(incidence is 84%);along the vascular wall showing strong fluorescence(incidence is 72%).Conclusions:1 Fundus autofluorescence can be used as a medical examination method for valuation the prognosis of idiopathic macular hole.2 BL-FAF image of idiopathic macular hole on postoperative 1 month exist correlation with poor repaired of macular area of visual function, the ELM defect diameter and the IS/OS defect diameter.3 NIR-FAF image of idiopathic macular hole on postoperative 1 month exist correlation with poor repair of the ELM defect diameter and the IS/OS defect diameter.4 Summarizes the NIR-FAF image characteristics of postoperative idiopathic macular hole. |
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