摘要目的 观察巩膜扣带手术(SBS)后周边视网膜自身荧光(AF)的变化.方法 采用广视野AF成像系统(Optos 200Tx)对成功行SBS的患者46例46只眼进行周边视网膜AF检查.对比周边视野检查结果,对手术区AF变化与视功能改变进行多元线性逐步回归分析.结果 手术后1周,AF检查显示,冷冻区视网膜色素上皮(RPE)完全萎缩性AF消失者15只眼,占32.6%.出现密度不均的AF增强区域,内部相间散在的弱AF分布者31只眼,占67.4%.冷冻导致的RPE萎缩面积超过视网膜裂孔面积4倍者9只眼,占19.6%;RPE萎缩面积在视网膜裂孔面积2～4倍者11只眼,占23.9%;RPE萎缩面积在视网膜裂孔面积2倍以内者26只眼,占56.5%.巩膜加压或环扎脊处出现视网膜AF强荧光者11只眼,占23.9%;巩膜加压脊处视网膜AF表达正常者35只眼,占76.9%.多元线性逐步回归分析显示,在α=0.05水平上,AF变化的面积与周边视野的垂直径与水平径均有显著相关性(标准化后回归系数β=-0.024、-0.019,P＜0.001);与最佳矫正中心视力不相关(F=51.22,P=0.312).结论 SBS后可伴有周边视网膜AF的改变;周边视网膜AF可用作RPE手术源性损伤的检测.

abstractsObjective To observe the changes of autoflurorescence (AF) in periphery retina after scleral buckling.Methods The examination of peripheral fundus autoflurorescence with Optos 200Tx was performed in 46 patients (46 eyes) who underwent successful scleral buckling. The correlation between changes of AF in surgical area and visual function were analyzed by multiple linear stepwise regression analysis. Results One week after surgery, completely atrophy of retinal pigment epithelium (RPE) with disappeared AF was found in the cryotherapy area of 15 eyes (32.6%), uneven area with enhanced AF and scattered weak AF spots was found in 31 eyes (67.4%). The area of RPE atrophy caused by cryocoagulation was 4 times larger than that of the primary retinal tear or holes in 9 eyes (19.6%), and was 2 to 4 times larger in 11 eyes (23.9%), and was 2 times less in the rest of 26 eyes (56.5%). A few granular hyper-AF was observed at the compressed retinal area in 11 eyes (23.9%), normal AF was observed at the compressed retinal area in 35 eyes (76.9%). When α = 0.05, the area with AF changes was significantly correlated with both vertical and horizontal diameter of peripheral visual filed (β=-0.024,-0.019; P＜0.001), but was not correlated with the best corrected visual acuity (F=51.22, P=0.312)by multiple linear stepwise regression analysis. Conclusions SBS can cause peripherial AF changes.Peripheral AF examination is helpful to evaluate the surgical retinal damage of scleral buckling.