国际眼科纵览 ›› 2025, Vol. 49 ›› Issue (4): 284-289.doi: 10. 3760/cma.j.cn115500-20241214-25408

• 综述 • 上一篇    下一篇

特发性黄斑裂孔术后视力预测的新进展

陈欣 杨娜 郑岩 张月玲   

  1. 保定市第一中心医院眼科,河北保定 071000
  • 收稿日期:2024-12-14 出版日期:2025-08-22 发布日期:2025-08-12
  • 通讯作者: 张月玲,Email:bdjfqlz@ 163.com E-mail:bdjfqlz@163.com

New progress in visual prediction after idiopathic macular hole surgery

Chen Xin, Yang Na, Zheng Yan, Zhang Yueling   

  1. Department of Ophthalmology, the First Center Hospital of Baoding, Baoding Hebei 071000, China
  • Received:2024-12-14 Online:2025-08-22 Published:2025-08-12
  • Contact: Zhang Yueling, Email: E-mail:bdjfqlz@163.com

摘要: 特发性黄斑裂孔是导致中心视力下降的常见疾病之一,玻璃体切除联合内界膜剥除术是标准术式。术后裂孔闭合率虽高,但视功能恢复程度个体差异显著,受多种因素影响。既往可通过相干光断层扫描测量裂孔最小直径、裂孔高度和基底直径的比值以及外界膜和椭圆体带的完整性等来预测和评估术后视力的恢复情况,目前有一些新的手段和因素可以预测手术成功后的视功能恢复情况,例如术前分别采用微视野计和多焦视网膜电图测量平均视网膜视敏度以及中央多焦点振幅值。另外,术后采用眼底自发荧光和自适应光学激光扫描检眼镜测量裂孔处的自发荧光状态和视锥细胞的密度,也能为临床医生在了解患者术后视功能恢复情况方面提供有力依据。特发性黄斑裂孔术后视力恢复是多因素交互作用的结果,术前精准评估裂孔特征以及术后长期随访是评估预后的关键。

关键词: 黄斑裂孔/特发性, 术后视力, 影响因素

Abstract: Idiopathic macular holes (IMH) are the most common causes of central vision loss, with vitrectomy combined with intraretinal membrane detachment being the standard surgical approach. While postoperative closure rates remain high, visual function recovery varies significantly among patients due to multiple factors. Traditional methods involved optical coherence tomography (OCT) measurements of the hole's minimum diameter, height-to-base diameter ratio, and the integrity of the outer membrane and the elliptical beltand other parameters to predict postoperative vision recovery. Emerging techniques now incorporate preoperative assessments using micro-optometry and multifocal retinal electroretinography (mfERG) to measure average retinal sensitivity and central foveal amplitude values. Postoperative evaluations through fundus autofluorescence and adaptive optical laser scanning (AOLS) for detecting spontaneous fluorescence at the hole site and measuring cone cell density provide crucial clinical insights into visual recovery. The visual recovery process following IMH is influenced by multiple interacting factors, with accurate preoperative assessment of hole characteristics and long-term follow-up being key to evaluation the prognosis outcomes.

Key words: Macular hole/ idiopathic, Postoperative visual acuity, Affective factor