| Background Rhegmatogenous retinal detachment is one of the most common blindness-causing diseases in ophthalmology.The incidence of rhegmatogenous retinal detachment is as high as5.52/10000.The application of silicone oil ensures the clinical and anatomical reattachment of retinal detachment,but the side effects can not be ignored.Silicone oil complications have been identified in recent years,including increased intraocular pressure,emulsification,inflammation,keratopathy,cataract and fiber gain.In the structure of the eyeball,the retina is in direct contact with silicone oil,and the function of the retina is the key to the formation of visual acuity.However,the toxic effect of silicone oil on the retina is still controversial.The application of optical coherence tomography is expected to solve this mystery,which can clearly show the hierarchical structure of the retina and make quantitative analysis of it.Objective To investigate the effect of silicone oil filling on retinal thickness in macular area after rhegmatogenous retinal detachment and the relationship between retinal thickness and visual function in macular area.Method Forty-five patients with rhegmatogenous retinal detachment were selected from March2017 to February 2018 in the first affiliated Hospital of Xinxiang Medical College and diagnosed as rhegmatogenous retinal detachment.The patients were divided into two groups according to the different operation methods.In the experimental group,25 patients(25 eyes)underwent vitrectomy and 20 eyes(20 eyes)in the control group were treated with vitrectomy and gas filling.Before operation,1 week after operation,1 month after operation,3 months after operation,6 months after operation,optical coherence tomography was performed to examine the nasal thickness of central concave area and inner ring area of macular,temporal side,superior retinal thickness and inferior retinal thickness.The best corrected visual acuity(best-corrected visual acuity,BCVA)was examined.The retinal thickness and visual acuity of macular area were compared between the two groups.Result1.Before operation,1 week after operation,1 month,3 months after operation,there was no significant difference in BVA between the two groups(P > 0.05).6 months after operation,the recovery of BCVA in the gas-filled group was better than that in the silicone oil-filled group(P < 0.05).There was a significant difference in the BCVA value between the two groups at different time points(F = 9.229,10.971,P < 0.05).1 week after operation,there was no significant difference in BCVA between the two groups before and after operation(P > 0 05),and the BVA of the two groups was higher than that before operation and 1 week after operation(P < 0 05),and there was no significant difference between the two groups at 1 month and 3 months after the operation(P < 0 05).6 months after operation,the BCVA of silicone oil-filled group was lower than that of 1 month and 3months after operation(P < 0.05),but there was no significant difference compared with pre-operation and 1-week post-operation(P > 0.05).6 months after operation,the BCVA value of the affected eyes in the gas-filled group was higher than that before operation and one week after operation(P < 0.05),but there was no significant difference between the two groups at the 1st and 3rd month after operation(P > 0.05).2.Before operation,1 week after operation,1 month,3 months after operation,there was no significant difference in retinal thickness between the two groups in the central concave area and inner ring area of the macular region(P > 0.05),and there was no significant difference in retinal thickness between the two groups(P > 0.05).At 6 months after operation,the thickness of the nasal side,temporal side and inferior retina in the central concave area and inner ring area of the affected eyes was significantly larger than that in the silicone oil-filled group(P < 0.05).There were significant differences in nasal,temporal,superior and inferior retinal thickness between the two groups at different time points(silicone oil-filled group: F = 14.706,19.573,24.72,25.737,38.725,P < 0.01,P <0.01).In the gas-filled group,F = 16.836,30.241,11.804,23.844,17.927,P < 0.05).One week after operation,the retinal thickness in the central concave area and inner ring area of macular area in the two groups was significantly higher than that before operation(P <0.05).At the 1st and 3rd month after operation,the retinal thickness in the central concave area and inner ring of macular area in the two groups was significantly lower than that in the first week after operation(P < 0.05),but there was no significant difference between the two groups(P > 0.05).At the 6th month after operation,the retinal thickness in the central concave area and inner ring of macular area in the two groups was significantly lower than that in the first week after operation(P < 0.05).In the silicone oil-filled group,the thickness of the nasal,temporal and inferior retinas in the central concave area and inner ring area of the macular was significantly lower than that in the preoperative a and 3months after operation(P < 0.05).There was no significant difference in retinal thickness between the gas-filled group and the central concave area and inner ring area of macular area before operation and 1 month and 3 months after operation(P > 0.05),but there was no significant difference in retinal thickness between the two groups(P > 0.05).3.There was a significant correlation between retinal thickness and BCVA at each time point after operation in the two groups,but no correlation was found in the other areas(p > 0.05),but there was no correlation between the retinal thickness in the central concave area of the macula and the retinal thickness.Conclusion1.The toxic effect of silicone oil on retina results in the decrease of retinal thickness.2.BCVA was correlated with the thickness of macular fovea,but not with the thickness of paracaval retina. |
PDF Full Text Request