病理性近视的相干光断层扫描  

The image futures of optical coherence tomogtaphy in pathologic myopia

作　　者：王光璐[1] 王明扬[1] 熊颖[1] 

机构地区：[1]首都医科大学北京同仁眼科中心,100730

出　　处：《中华眼科杂志》2004年第9期597-600,共4页Chinese Journal of Ophthalmology

摘　　要：目的　研究病理性近视的相干光断层扫描 (OCT)的图像特征。方法　对 10 0例 (195只眼 )高度近视患者行OCT检查。患者年龄 16～ 76岁。屈光度数 - 6 0 0～ - 36 0 0D。结果　OCT检查正常者 7只眼 (3 6 % ) ,视网膜色素上皮及脉络膜毛细血管光带不均匀和薄变者 16 1只眼 (82 6 % ) ,黄斑全层裂孔 2 1只眼 (10 8% ) ,其中合并视网膜脱离 10只眼 (5 1% ) ,黄斑限局性视网膜浅脱离 2 4只眼 (12 3% ) ,其中合并视网膜劈裂 7只眼 (3 6 % ) ,黄斑脉络膜新生血管膜 19只眼 (9 7% ) ,Fuchs斑 9只眼 (4 6 % ) ,厚的黄斑出血 3只眼 ,黄斑前膜 18只眼 (9 2 % ) ,常合并有视网膜水肿。黄斑视网膜神经上皮薄变 5只眼 (2 6 % ) ,漆裂纹 3只眼 (1 5 % )。结论　与裂隙灯全视网膜显微镜检查比较 ,OCT在观察视网膜色素上皮和脉络膜毛细血管改变 ,确诊黄斑裂孔 ,发现小的神经上皮脱离和劈裂 ,诊断黄斑前膜 ,神经上皮薄变等方面均有优越性。但对薄的黄斑出血及小色素点不能分辨 ,对厚出血与色素难以分辨 ,因而也有其局限性。Objective To study the characteristics of optical coherence tomography(OCT) pictures in pathologic myopia.Methods 100 cases (195 eyes) of pathologic myopia were examined with OCT. The Age ranges of all the cases was 16-76 years and refraction error was-6.00--36.00 diopters.Results OCT image was normal in 7 eyes(4.3%), the reflectivity band of RPE and chorio-capillaries were uneven and thinning in 147 eyes (90.2%). Full-thickness macular hole was found in 21 eyes (10.8%), of which 10 (5.1%) eyes were associated with retinal detachment ; local shallow retinal detachment was found in 24 eyes (12.3%) ,of which 7 eyes (3.6%) were associated with retinal schisis, 19 eyes (9.7%) with macular choroidal neovascularization(CNV). retinal swelling was often associated with the following diseases: Fuchs spot 9 eyes (4.6%), thick macular hemorrage 3 eyes, epiretinal macular membrane 18eyes(9.2%); macular sensory retina thinning in 5 eyes(2.6%). Conclusion Compared with fundus examinction including slit lamp with pan-retinoscope, OCT showed unique preference for observation of the changes of retinal pigment epithelium(RPE), chorio-capillary layer, diagnosis macular hole and epiretinal macular membrane, discovery of small sensory retinal detachment, schisis and thinning of sensory retina layer etc. OCT can not either discover a piece of thin macular hemorrhage or differentiation between thick macular hemorrhage and pigment spot.

关 键 词：视网膜色素上皮 断层扫描 病理性近视 神经上皮 黄斑出血 OCT 黄斑前膜 相干光 层裂 分辨 

分 类 号：R778.11[医药卫生—眼科]