ABSTRACT
@#AIM: To investigate the correlation between retinal microstructural changes and visual function after scleral buckling and vitrectomy with rhegmatogenous retinal detachment.<p>METHODS: Prospective clinical study was conducted. With PVR grade B-C1, 75 patients with 75 eyes of aged 15-30 years who were macular-off retinal detachment were selected. PPV was performed for posterior equatorial retinal hiatus(35 eyes, PPV group), and SB was performed for anterior equatorial retinal hiatus(40 eyes, SB group).The patients in the two groups were followed up for 6mo to observe the changes in the best corrected visual acuity(BCVA)and retinal microstructures.<p>RESULTS: Compared with SB group, the probability of inner sensory layer/outer sensory layer and inner boundary membrane fracture after operation in PPV group was 2.812 times, with a statistically significant difference(<i>P</i>=0.020), and the probability of subretinal effusion was 0.115 times, with a statistically significant difference(<i>P</i><0.001). There was no statistically significant difference(<i>P</i>=0.700)between the two groups. And with the extension of observation time, the possibility of inner sensory layer/outer sensory layer and inner boundary membrane, persistent subretinal fluid and interlayer effusion in the two groups of patients gradually decreased. After the operation, the thickness of the neurosensory retinal and outer nuclear layer in the two groups gradually increased, and BCVA gradually improved. With the prolonging of observation time, the thickness of the neurosensory retinal in SB group increased greatly, and BCVA recovered better.<p>CONCLUSION: The integrity of the inner sensory layer/outer sensory layer and inner boundary membrane, subretinal effusion, interlaminar effusion, and the thickness of the neurosensory retinal are the key factors affecting the recovery of visual function after SB or PPV.
ABSTRACT
Objective To observe the retinal microstructure changes in patients with rhegmatogenous retinal detachment following vitrectomy procedures and its correlation with the best corrected visual acuity (BCVA).Methods Patients who were diagnosed with rhegmatogenous retinal detachment and underwent vitrectomy were recruited in this study.BCVA and optical coherence tomography (OCT) examination were performed at 1 week,1 month,3 months and 6 months after operation for recording the neurosensory retinal thickness and outer nuclear layer thickness as well as observing the occurrence of ellipsoid zone,external limiting membrane rupture,macuiar edema,macular epiretinal membrane.Results A total of 32 eyes from 31 patients were followed up,and the BCVA became better as the follow-up prolonged.Both neurosensory retinal thickness and outer nuclear layer thickness thickened from 1 week [(122.75 ± 111.84) μm and (79.06 ±76.67) μm] to 3 months [(163.28 ± 133.10) μm and (108.66 ± 120.40)μm],and slightly thinned at 6 months [(159.50 ± 99.26) μm and (99.22 ± 74.89) μm].AS follow-up went by,the occurrence rate of ellipsoid zone and external limiting membrane rupture were 68.8％ and 53.1％,65.6％ and 46.9％,56.3％ and 40.6％,50.0％ and 37.5％ at 1 week,1 month,3 months,6 months,respectively,and both variables were significantly correlation with the patients' BCVA.Conclusion The neurosensory retinal thickness and outer nuclear layer thickness in patients with rhegmatogenous retinal detachment became gradually thicker and the vision became better during follow-up.Meanwhile,the ellipsoid zone and external limiting membrane rupture are the key factors for patients' BCVA.