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目的 观察板层黄斑裂孔(LMH)相关视网膜前增生膜(LHEP)的OCT图像特征.方法 回顾性病例分析.2013年1月至2016年12月在成都市第三人民医院眼科经频域OCT (SD-OCT)检查确诊的LMH患者128例133只眼、全层黄斑裂孔(FTMH)患者202例212只眼纳入研究.其中,LMH 133只眼中,有无LHEP者分别为53(39.8％)、80(60.2％)只眼;FTMH 212只眼中,有无LHEP者分别为12(5.7％)、200 (94.3％)只眼.LMH患者中,有无LHEP者平均年龄分别为(70.88±10.98)、(64.76±13.60)岁;两者平均年龄比较,差异有统计学意义(U=1521.5,P=0.006).采用SD-OCT仪对黄斑区进行扫描,测量LMH的裂孔内径、中径及基底部厚度;FTMH的裂孔高度、裂孔基底直径、裂孔最小直径.对比观察有无LHEP的LMH患眼裂孔内径、中径及基底部厚度、椭圆体带完整性;计算有LHEP的FTMH患眼的裂孔牵拉指数(THI)、裂孔指数(MHI).LMH患眼有无LHEP者之间裂孔内径、中径、基底部厚度比较行独立样本t检验或秩和检验;椭圆体带受损率比较行,检验.结果 LMH患眼中有无LHEP者,平均裂孔内径分别为(611.15±209.83)、(521.70±198.05) μm;平均裂孔中径分别为(961.22±571.09)、(497.01±172.30) μm;平均基底部厚度分别为(99.83±38.69)、(154.12±43.17) μm.两者平均裂孔内径(t=2.490)、中径(t=5.747)、基底部厚度(t=-7.395)比较,差异均有统计学意义(P=0.014、0.000、0.000).有LHEP者53只眼中,椭圆体带受损50只眼(94.34％);无LHEP者80只眼中,椭圆体带受损17只眼(21.25％);两者椭圆体带受损率比较,差异有统计学意义(x2=68.126,P=0.000).FTMH患眼有LHEP者12只眼中,THI＜1.0且MHI＜0.5者10只眼.结论 LMH有LHEP患眼裂孔内径与中径均明显大于无LHEP患眼;其基底部更薄;椭圆体带受损率更高.

Objective To observe the OCT characteristics of lamellar hole-associated epiretinal proliferation (LHEP).Methods A retrospective case analysis.A total of 128 patients (133 eyes) with lamellar macular hole (LMH) and 202 patients (212 eyes) with full-thickness macular hole (FTMH) diagnosed by the examinations of spectral-domain OCT (SD-OCT) in Department of Ophthalmology,The Third People's Hospital of Chengdu from January 2013 to December 2016 were included in this study.Among 133 eyes with LMH,there were 53 eyes (39.8％) with LHEP and 80 eyes (60.2％) without LHEP.Among 212 eyes with FTMH,there were 12 eyes (5.7％) with LHEP and 200 eyes (94.3％) without LHEP.The mean age of LMH with or without LHEP patients were 70.88± 10.98,64.76± 13.60 years old,respectively.The difference of mean age between LMH with or without LHEP patients was statistically significant (U=1521.5,P=0.006).The inner diameter,median diameter and base thickness of the LMH,the height,base diameter and minimum diameter of FTMH were measured by SD-OCT.The traction index (THI) and the macular hole index (MHI) were calculated.An independent sample t-test or rank-sum test was used to compare the inner diameter,median diameter,and base thickness of the LMH in patients with or without LHEP,and x2 test was used to compare the injury rate of ellipsoid zone.Results Of the LMH patients with or without LHEP,the inner diameter were 611.15 ± 209.83 and 521.70± 198.05 μm,the median diameter were 961.22 ± 571.09 and 497.01 ± 172.30 μm,the base thickness were 99.83 ± 38.69 and 154.12± 43.17 μm.The differences of the inner diameter,median diameter and the base thickness between LMH patients with or without LHEP were statistically significant (t=2.490,5.747,-7.395;P=0.014,0.000,0.000).Among the 53 eyes with LHEP,There were 50 eyes (94.34％) were injured in ellipsoid zone among 53 eyes with LHEP,while 17 eyes (21.25％) were injured in ellipsoid zone among 80 eyes without LHEP.The injury rate of ellipsoid zone between LMH patients with or without LHEP was statistically significant (x2=68.126,P=0.000).In 12 eyes of FTMH with LHEP,there were 10 eyes with THI＜ 1.0 and MHI＜0.5.Conclusion Compared with the LMH without LHEP,the LMH with LHEP has larger inner diameter and median diameter,thinner base and higher injury rate of ellipsoid zone.