目的 评价频域光学相干断层成像技术(SD-OCT)在观察玻璃体切割术对糖尿病视网膜病变患者黄斑部视网膜病变影响中的应用价值.方法 选取2013年7月至2014年10月我院收治的85例糖尿病视网膜病变患者接受单侧玻璃体切割术,同时选取16例(22眼)正常志愿者作为对照组.常规进行闭合式玻璃体切割术,并在新生血管处根据具体情况补充光凝.术后1天、2周、1个月、2个月,利用SD-OCT进行黄斑部扫描,并用分析软件进行九分区的自动分析,记录各区视网膜厚度数据和黄斑区视网膜平均厚度.结果 正常对照组黄斑部视网膜厚度平均为(310.71 ± 30.87)μm,黄斑中心凹 (259.36 ± 18.14)μm.患者术后1天黄斑部视网膜厚度平均为(426.72 ± 41.49)μm,黄斑中心凹平均为(427.86 ± 247.16)μm,均显著高于正常对照组.术后2周厚度平均减少42.48 μm(9.96％),术后1个月平均减少73.13 μm(17.37％),治疗后2个月平均减少111.51 μm (26.06％),差异均有统计学意义(P＜0.05).治疗前后视力差异无统计学意义(P＞0.05).结论 SD-OCT能直观地了解术后黄斑区视网膜病变的转归情况,可以作为黄斑水肿诊断和长期随访的有效检查手段.玻璃体切割术治疗糖尿病视网膜病变,可降低黄斑区视网膜厚度.%Objective To evaluate the macular retinal structure after vitrectomy for diabetic retinopathy( DR) by using spectral-do-main optical coherence tomography( SD-OCT) . Methods Eighty-five patients with DR in our hospital from July 2013 to October 2014 were selected as the observation group, while 16 normal subjects(22 examined eyes)were selected as the control group. All patients were treated with the standard vitrectomy, and some patients combined with laser photocoagulation. SD-OCT was applied to the patients 1 day, 2 weeks, one month and two months after the treatment. Visual acuities and fundus examination were applied to the patients before and after operation. Results The thickness of macula was 310. 71 ± 30. 87μm in control group, and of macula central fovea was 259. 36 ± 18. 14μm. On 1st day after surgery, the macular retinal thickness was 426. 72 ± 41. 49μm, macula central fovea was 427. 86 ± 247. 16μm, both of which were sig-nificantly higher than those of the control group ( P＜0. 05 ) . After 2 weeks, the thickness of macular retina had a median of 42. 48 μm (9. 96％)decrease from 1st day after surgery, and after one month there was 73. 13μm(17. 37％), and two months 111. 51μm(26. 06％). The differences had statistical significance(P ＜0. 05). However,visual acuities before and after treatment had no statistical significance.Conclusion In eyes with diabetic macular edema after surgery, the foveal thickness may be significantly decreased after vitrectomy, which may be effective in treating diabetic macular edema since SD-OCT can visually observe the prognosis of macular retinal lesions.
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