目的评估掺钕钇铝石榴石(Nd∶YAG)玻璃体激光消融治疗有症状玻璃体混浊的有效性。
方法采用系列病例观察研究，纳入2021年6月至2022年9月于深圳市眼科医院确诊的生理性玻璃体混浊并使用Nd∶YAG玻璃体激光消融治疗者44例44眼。治疗前及末次治疗后2个月，采用标准对数视力表测量患者最佳矫正视力(BCVA)，采用共焦激光扫描系统的玻璃体红外照相测量患眼治疗前后玻璃体混浊物面积，采用双通道视觉质量分析仪(OQAS-Ⅱ)测量治疗前后的客观散射指数(OSI)值，记录随访期间并发症发生情况。统计比较各指标差异，并采用简单线性回归模型分析混浊物面积与OSI的关系。
结果Nd∶YAG激光消融治疗前后BCVA比较差异无统计学意义( t＝－0.478， P＝0.635)。激光消融治疗前混浊物面积为(3.043±1.942)mm 2，明显大于治疗后的(1.074±0.735)mm 2，差异有统计学意义( t＝0.769， P<0.001)。激光消融治疗前OSI值为1.976±0.975，明显高于治疗后的1.560±0.796，差异有统计学意义( t＝0.730， P<0.001)。线性回归分析结果显示，OSI值＝1.45＋0.16×玻璃体混浊物面积( F＝5.681， P＝0.020)。治疗后2个月未见视力下降及眼压升高者，未见外伤性白内障、视网膜损伤及裂孔发生。
结论OQAS Ⅱ系统的OSI值及玻璃体混浊物面积可作为客观评估Nd∶YAG玻璃体激光消融治疗有效性的量化评价指标。
ObjectiveTo evaluate the effectiveness of yttrium aluminum garnet (Nd∶YAG) laser vitreolysis in the treatment of symptomatic vitreous opacity.
MethodsAn observational case series study was performed.Forty-four eyes of 44 patients diagnosed as physiological vitreous opacity in Shenzhen Eye Hospital from June 2021 to September 2022 and treated with Nd∶YAG laser vitreolysis were enrolled.Before treatment and 2 months after last treatment, best corrected visual acuity (BCVA) evaluated with standard logarithmic visual acuity chart, floater areas calculated through infrared fundus photography, and objective scattering index (OSI) obtained by the Optical Quality Analysis System (OQAS) were recorded.The occurrence of complications during the follow-up period was recorded.The differences in each indicator were compared, and a simple linear regression model was used to analyze the relationship between floater area and OSI.This study adhered to the Declaration of Helsinki and was approved by the Medical Ethics Committee of Shenzhen Eye Hospital (No.2021-6-3).Patients were informed of the study methods and purposes.Written informed consent was obtained from each subject.
ResultsThere was no significant difference in BCVA before and after Nd∶YAG laser vitreolysis ( t=-0.478, P=0.635).The floater area before laser treatment was (3.043±1.942)mm 2, which was significantly larger than (1.074±0.735)mm 2 after laser treatment ( t=0.769, P<0.001).The OSI before laser treatment was 1.976±0.975, which was significantly greater than 1.560±0.796 after laser treatment ( t=0.730, P<0.001).The results of linear regression analysis showed that the OSI=1.45+ 0.16× floater area ( F=5.681, P=0.020).No patient had visual acuity loss or intraocular pressure increase and no traumatic cataract or retinal damage occurred.
ConclusionsAfter laser treatment, the floater area decreased, the OSI decreased, and the visual quality of patients improved.The OSI from OQAS Ⅱ and floater area can be used as quantitative evaluation indicators to objectively evaluate the effectiveness of Nd∶YAG laser vitreolysis.
黄灿凤,王林丽,宁家凤,等. 玻璃体激光消融治疗有症状玻璃体混浊有效性量化评估[J]. 中华实验眼科杂志,2025,43(01)：47-51.
DOI:10.3760/cma.j.cn115989-20240122-00024版权归中华医学会所有。
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黄灿凤：酝酿和设计试验、文章撰写、统计分析；王林丽：酝酿和设计试验、采集及分析/解释数据；宁家凤、甘润：采集及分析/解释数据；闫晓河：参与酝酿和设计试验；陈青山：酝酿和设计试验、实施研究、对文章的知识性内容作批评性审阅及定稿
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