光相干断层扫描在观察特发性黄斑裂孔病程进展中的应用  

Application of coherence tomography in the course of idiopathic macular hole

作　　者：戴虹[1] 李永[1] 龙力[1] 卢颖毅[1] 陈彤[1] 师自安[1] 

机构地区：[1]北京医院眼科,100730

出　　处：《中华眼底病杂志》2005年第2期79-82,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的　应用光相干断层扫描 (OCT)对临床诊断为 ～ 期特发性黄斑裂孔患眼进行随诊观察 ,了解其裂孔进展过程及与玻璃体后分离的相互关系。　方法　按 Gass的临床分期标准 ,结合 OCT图像特征 ,诊断特发性黄斑裂孔 ～ 期未行手术治疗的 72只眼 ,进行 OCT随诊检查。　结果　 ～ 期裂孔分别为 2 3、19、11、19只眼 ,随诊时间最长 4 3个月 (平均 13.4个月 ) ,每只眼 OCT检查次数 2～ 10次(平均 4 .7次 ) ,在随诊期间 , 期裂孔 2 3只眼 ,9只眼 (39.1% )进展为 ～ 期裂孔 ,2只眼玻璃体后脱离(PVD)后中心凹曲线恢复正常 ; 期裂孔 19只眼 ,13只眼 (6 8.4 % )进展为 ～ 期裂孔 ,有 1只眼 PVD后裂孔自行愈合 ; 期裂孔 11只眼 ,5只眼 (45 .5 % )进展为 期裂孔 ,1只眼 12个月后裂孔部分自行愈合。OCT图像显示 ,玻璃体从黄斑中心凹周围开始与视网膜分离 ,直至完全后脱离的过程与黄斑裂孔进展过程一致。在随诊期间 ,15只眼因病程进展接受手术治疗。　结论　黄斑裂孔形成和发展与玻璃体后脱离的发生密切相关。OCT可直观显示黄斑裂孔的进展变化 ,对提供 IMH的分期诊断和手术指征有较大帮助。Objective To investigate the course of the idiopathic macular hole (IMH) clinically diagnosed as at stage Ⅰ-Ⅳ by optical coherence tomography (OCT), and analyze the relationship between the posterior vitreous detachment (PVD) and the course of IMH. Methods Hadn′t undergone any operation, periodical OCT were performed on 72 eyes of 58 patients with IMH at stage Ⅰ-Ⅳ confirmed by Gass standard and the features of OCT images. Results The longest follow-up period was 43 months (average 13.4 months), and the examine times of OCT on each eye were between twice to 10 times (average 4.7 times). During the follow-up period, 23 eyes were in stage I in which 9 (39.1%) developed to stage II and 2 had recovered normal curve of fovea after PVD; 19 were in stage II in which 13 (68.4%) developed to Ⅲ-Ⅳ and 1 had closed hole after PVD; 11 were in stage III in which 5 (45.5%) developed to stage IV and 1 had partly closed hole 12 months later. The images of OCT showed that the process of macular hole was consistent with the course that vitreous depart from retina from the circumference of fovea till entire posterior detachment.Fifteen affected eyes in this series of patients had undcrygong surgical treatment due to serious progression of IMH in follow-up period. Conclusions There is a close relationship between the formation and development of macular hole and the occurrence of PVD. OCT can show the progress of the macular hole directly and offer an important technique in diagnosis, classification and surgical treatment of IMH.

关 键 词：特发性黄斑裂孔 随诊 OCT 光相干断层扫描 病程进展 中心凹 愈合 过程 结论 帮助 

分 类 号：R774.5[医药卫生—眼科]