iOCT在病理性近视黄斑病变手术中的应用

doi:10.3760/cma.j.cn115909-20190701-00190

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Abstract Objective: To evaluate the feasibility of intraoperative optical coherence tomography (iOCT) for vitreous macular surgery in pathological myopic macular diseases and investigate the value of the intraoperative application. Methods: This was a retrospective case series study. Chosen patients underwent vitrectomy for epiretinal membrane (ERM), macular hole (MH), macular foveoschisis (MF), vitreomacular traction syndrome (VMT) and other pathological myopic macular diseases from May 2015 to December 2017 in Eye Hospital, Wenzhou Medical University. Vitreoretinal surgery was performed on all eyes and iOCT scans qualitatively assessed intraoperative retinal changes, included intraoperative micro injuries, accuracy of surgical techniques, changes at the margin of the holes, et al, and the application of iOCT was evaluated.Results: A total of 29 eyes were chosen. The patients included 9 males and 20 females with an average age of 58.8±10.3 years and an average axial length of 28.9±2.0 mm. Fourteen eyes were diagnosed with ERM, 7 eyes with MH, 4 eyes with MF, 3 eyes with VMT and 1 eye with PRM. iOCT confirmed intraoperative micro injuries or abnormalities in 7 eyes (7/29), including 6 eyes with abnormal layers of nerve fibers and 1 eye with an elevated inner retina. A residual membrane after peeling was identified in 4 eyes with ERM (4/14). After peeling, iOCT revealed the change at the margin of the hole in 3 eyes with MH (3/8). iOCT showed there was no macular hole after peeling in all 4 eyes with MF. An MF case combined with MH was undefined by OCT preoperatively but was confirmed by iOCT. Three eyes with intraoperative fovea reservation or ILM reversal coverage technique were all confirmed in iOCT images. Conclusions: iOCT can help to assess membrane peeling integrity, intraoperative micro injuries and the accuracy of surgical techniques while surgery is in progress. It can also help surgeons improve the diagnosis rate of macular hole, and observe the changes at the margin of the hole after peeling. iOCT has some application value for concurrently monitoring vitreoretinal surgery in pathological myopic macular disease.

Key words： intraoperative optical coherence tomography pathological myopic macular disease vitreoretinal surgery

Received: 01 July 2019

Fund:National Natural Science Foundation of China (81700884)

Corresponding Authors: Lijun Shen, Eye Hospital, Wenzhou Medical University, Hangzhou 310000, China (Email: slj@mail.eye.ac.cn)

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https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20190701-00190 OR https://www.cjoovs.com/EN/Y2020/V22/I6/415

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