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Microstructure change after scleral bucking and vitreous in thetreatment of macula-off rhegmatogenous retinal detachmentObjective:Spectral domain-optical coherencetomography,SD-OCT)was used to compare the ultrastructural recovery of the macular area after two kinds of procedures.Methods:Thirty-seven eyes(37 eyes)of 37 patients with macula-off rhegmatogenous retinal detachment were enrolled in the Department of Ophthalmology,Second Hospital of Hebei Medical University from December2015 to December 2016.At preoperative,postoperative 7 days,1 month and 3months examine BCVA and SD-OCT.Morphological changes of retinal layers in the fovea of macula were observed by SD-OCT.Measured: subretinal fluid(SRF)height.Results:1 In PPV group one-time operation success rate is 100%;In SB group,of which 2 eyes for the first time the operation was unsuccessful,the second of vitrectomy and reset achievement,the reset rate was 87.5%2 In the PPV group,the height of the subretinal fluid was 957.10 ±507.35?m,20.32 ± 39.31?m,15.10 ± 34.26?m,12.38 ± 28.48?m before operation,7 days,1 month and 3 months after operation.The height of subretinal fluid in SB group was 454.63 ± 408.28?m,135.60 ± 94.31?m,104.63 ± 67.67?m,86.75 ±53.23?m,and the non-parameters(Mann-Whitney U test)were performed in the two groups before,7 days,1 month and 3 months after operation.The difference was statistically significant.As can be seen from the figure,the two groups were the fastest decline after 7 days,then the trend slows down.3 There was no significant difference between the two groups about IS /OS fragmentation and the incidence of external membrane imperfections.4 1 eye had macular atrophy,1 eye macular edema,1 eye retinal epiretinal membrane in the PPV group at 3 months postoperatively.There were no macular changes in the SB group.5 The average BCVA increased 1.06 ±0.52 log MAR in PPV group;The average BCVA increased 0.79 ± 0.53 log MAR in SB group,the average visual acuity was significantly higher than that of SB group,and the difference was statistically significant.Conclusion:1 PPV surgery contributes to anatomical restoration of the macula and no significant subretinal fluid,resulting in better postoperative visual acuity.2 PPV surgery may have macular abnormal changes such as macular atrophy,macular edema and retinal membrane,but because of the small sample size,the incidence of abnormal lesions is low,the results have a greater deviation.3 Two groups of early subretinal fluid absorption faster,after postoperation 7 days the speed gradually slowed down.Part ? The relevant study of subfoveal fluid and the thickness of thesubfoveal choroid after scleral buckling and vitreous in thetreatment of macula-off rhegmatogenous retinal detachmentObjective: With the use of EDI-SD,the height of subfoveal retinal fluit and thickness of the choroid were recorded and compared.The relationship between the thickness of the choroid and the subretinal fluid was studied and search the persistence subretinal fluid causes.Methods: Forty eyes(37 eyes)of 37 patients with macula-off rhegmatogenous retinal detachment were enrolled in the Department of Ophthalmology,Second Hospital of Hebei Medical University from December 2015 to December 2016.At preoperative,postoperative 7 days,1month and 3 months examine EDI SD-OCT.Morphological changes of retinal layers in the fovea of macula were observed by SD-OCT.Measured: subfovealchoroid thickness(SFCT),and 3 mm above,below,nasal to and temporal to the fovea were measure by EDI SD-OCT.Results:1 The average trend of SFCT,ICT3.0,SCT3.0,NCT3.0,TCT3.0 in preoperative,7 days postoperatively,1 month and 3 months postoperatively were gradually increased.Reached the highest level at 7 days after operation and decreased gradually,reaching the preoperative level at 3 months after operation.2 The trend of SFCT,SCT3.0,ICT3.0,NCT3.0,TCT3.0 in preoperative,7days postoperatively,1 month postoperatively and 3 months postoperatively was gradually increased.Reached a maximum at 7 days postoperatively,and then decreased gradually,and remained below the preoperative level at 3months after the last follow-up.Preoperative SFCT(194.25 ± 56.87 um)and SFCT of each time point by paired t test at,SFCT of 1 month(176.13 ± 51.84um)and 3 months after surgery(176.69 ± 53.03 um)compared with preoperative SFCT,the difference was statistically significant,7 days after surgery(205.19 ± 56.25 um)compared with preoperative,difference was not statistically significant.There was no significant difference in the thickness of choroids of the buckled and unbuckled from the foveal 3mm at 7 days,1month and 3 months after operation.3 The highness of the submacular fluid at 7 days,1 month and 3 months after operation were compared with the thickness of the choriod of the cingulate side that distanced from the macular fovea 3mm by Spearman Rank correlation analysis showed that there was no linear relationship at three time points.The submacular fluid height was analyzed with the corresponding time of macular fovea choriod thickness at 7 days,1 month and 3 months after operation.There was no linear relationship between the choriod thickness of the macular fovea at the time point.Conclusion:1 The choroidal thickness of PPV group and SB group was significantly increased after operation,and reached the highest level at 7 days afteroperation,then decreased,PPV group could reach the preoperative level,SB group was lower than the preoperative level.2 There was no linear relationship between the subretinal fluid and the choroidal thickness of any location.From this we can think that the choroidal blood had no effect on the subretinal fluid in SB group. |
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