方法：本研究共搜集了本院门诊CME患者52例57眼，患者均应用OCT确诊为黄斑囊样水肿，且在同1d进行眼底及最佳矫正视力检查。最佳矫正视力(BCVA)检查使用E视力表和对数视力表(logMAR)，视力范围2.3 logMAR～0 logMAR(均数1.11±0.57)。通过患者病史和眼底照相进行病因诊断，根据黄斑囊样水肿最大垂直直径和黄斑厚度比率将OCT分为四级(一级<30%，30%≤二级<60%，60%≤三级<90%，四级≥90%)，相关性是通过计算皮尔逊相关系数“r”值(P<0.05时有统计学意义)。

结果：OCT IV级患者视力最差(平均视力1.96±0.23 logMAR)，此时OCT分级与视力之间有显著正相关，统计学有显著差异(r=0.729，P<0.001)。视网膜中央静脉阻塞(CRVO)是引起视力严重下降最常见的疾病，(r=0.375，P=0.004)。另外根据OCT的形态，IS/OS层(inner segment/outer segment)和ELM(external limiting membrane)均破环的患者视力显著下降(平均视力1.11±0.57 logMAR)，二者间具有统计学差异(r=-0.346，P=0.008)。玻璃体视网膜牵拉和外视网膜层破坏均与OCT Ⅳ级和(r=0.390，P=0.003)CRVO呈正相关(r=0.362，P=0.006)，差异有统计学意义。

结论：当CME的OCT形态表现Ⅳ级时CRVO患者视力最差。

METHODS: Fifty-seven eyes with CME from 52 patients were included in our study. The data of this cross sectional study was collected from patients with CME assessed by OCT, who also underwent fundus photography and visual acuity test the same day. The best corrected visual acuity(BCVA)was assessed by using E chart and converted in logarithm of the minimum angle of resolution(logMAR). The visual acuity varied from 2.3 logMAR to 0 logMAR with a mean of 1.11±0.57. The etiology was determined from medical history and the fundus photograph of the patient. Four OCT grades established according to ratio between the vertical size of largest cyst and the maximum macular thickness(<30%, ≥30% <60%, ≥60% <90% and ≥90%)were considered. The correlation was established by calculating the Pearson's correlation coefficient “r” and the statistical significance was considered when P value was inferior to 0.05.

RESULTS: OCT grade IV was the most associated with very severe visual loss with the greatest mean VA of 1.96±0.23 logMAR and the correlation between OCT grades and visual acuity was strongly statistically significant(r=0.729, P<0.001). The central retinal vein occlusion(CRVO)was the most underlying disease associated with worse vision, with the greatest mean VA of 2 logMAR and the correlation was statistically significant(r=0.375, P=0.004). Another associated OCT pattern, the disruption of both inner segment/outer segment(IS/OS)and external limiting membrane(ELM), was inversely associated with severe visual loss(high mean VA=1.11±0.57 logMAR, with statistically significant correlation, r=-0.346, P=0.008). The presence of both vitreoretinal traction components and outer retinal layers disruption were significantly associated with OCT grade IV(r=0.390, P=0.003)and CRVO(r=0.362, P=0.006).

CONCLUSION: In this study, the OCT fourth grade and CRVO seem to be more significantly associated with the worse vision in patients with CME.