光学相干断层成像、共焦激光断层扫描和视网膜厚度分析在老年性黄斑变性检查中的对比研究  

Investigation of optical coherence tomography, Heidelberg retina tomography,retinal thickness analyzer in age-related macular degeneration

作　　者：陈松[1] 姜天乐[2] 崔兰君[1] 韩梅[1] 张珑俐[1] 

机构地区：[1]天津市眼科医院,300020 [2]北京世纪坛医院眼科

出　　处：《临床眼科杂志》2007年第1期3-6,共4页Journal of Clinical Ophthalmology

基　　金：天津市科技局社会发展科技项目(编号:033111411)

摘　　要：目的探讨光学相干断层成像(OCT)、共焦激光断层扫描(HRT)、视网膜厚度分析(RTA)检测老年性黄斑变性(AMD)不同类型病变的价值,为AMD早期诊断、病程预后及治疗提供依据。方法对AMD患者63例(97只眼)(萎缩型AMD65只眼、渗出型AMD32只眼)进行OCT、HRT、RTA检查,其中玻璃膜疣41只眼,地图状萎缩24只眼,脉络膜新生血管(CNV)22只眼,视网膜色素上皮脱离(PED)10只眼。结果(1)玻璃膜疣检测阳性率依次为OCT、RTA及HRT,OCT发现色素上皮层的局限性增厚,HRT检测未见明显异常,RTA显示黄斑区视网膜不同程度增厚。(2)地图状萎缩检测阳性率依次为OCT、HRT及RTA。OCT发现神经上皮及色素上皮层不同程度变薄,HRT可发现有视网膜局部的凹陷并可发现板层孔,RTA未发现有显著特征性改变。(3)CNV检测阳性率依次为OCT、RTA及HRT。OCT在CNV有特征性改变,HRT显示视网膜的隆起,RTA显示视网膜的局部增厚。(4)PED检测阳性率无显著性差异(F=8.400,P=0.136)。OCT在PED有特征性改变,并可区分浆液性及渗出性PED,HRT显示视网膜的隆起,RTA显示视网膜的增厚。结论对比三种技术,在鉴别AMD各型病变中OCT灵敏性及特异性最高。而三种技术间的协同作用在本研究中未发现有显著的统计学意义,待加大样本后再行分析。Objective To show the value of diagnosis of AMD in order to supply evidences which technology can be used to detect the certain AMD pathological changes and be helpful to illustrate the process of AMD. Methods Select the 63 patients（total 97 eyes） who were diagnosed for AMD in Tianjn eye hospital from Nov. ,2004 to Apr. ,2005, age from 52- 80 years old, visual activity from hand moving before eyes to 1. 0. Then by turns to receive the examinations through OCT/HRT/RTA and use the statistical treatment of Χ^2 to survey and evaluate the Results. Results （ 1） Results of drusen Comparing three technology＇ detection positive rate on this process, OCT is the first one, RTA is the second and HRT is the last （ P 〈 0.05 ）. OCT can detect the pathological changes of RPE and neural epithelium layer. RTA can find the alteration of retinal thickness when the visual activity is normal. HRT does not show any significant character on the process of drusen. （2） Results of geographical atrophy Comparing three technology＇ detection positive rate on this process, OCT is the first one, HRT is the second and RTA is the last （ P 〈 0.05 ）. OCT can detect the attenuation of RPE and neural epithelium layer. HRT can find the retinal depressed. RTA can only show alteration of retina in some cases. （ 3 ） Results of CNV Comparing three technology＇ detection positive rate on this process, OCT is the first one, RTA is the second and HRT is the last （ P 〈0.01）. OCT can distinguished CNV＇s vary shape and find the occult CNV behind the hemorrhage. HRT can detect eminence of retina. RTA can show the increased thickness result from edema of retina. （4） Results of PED Comparing three technology＇ detection positive rate on this process, there is no significant difference between them （ P 〉 0.05 ）. OCT can discriminate serosity PED and hemorrhagic PED. HRT can show retinal eminence for PED. RTA can find the obviously increased thickness of retina. Conclusions In the three technologies, OCT has the b

关 键 词：老年性黄斑变性 光学相干断层成像 共焦激光断层扫描 视网膜厚度分析 早期诊断 

分 类 号：R774.5[医药卫生—眼科]