三维频域光学相干断层扫描对黄斑前膜诊断和分型的应用价值  

Value of spectral optical coherence tomography on idiopathic epiretinal membrane diagnosis and morphological categorization

作　　者：王应利[1] 冯炜[2] 郭纯刚[1] 李冬[1] 凌宇[1] 

机构地区：[1]北京煤炭总医院眼科,北京100028 [2]北京煤炭总医院耳鼻咽喉科,北京100028

出　　处：《中日友好医院学报》2010年第3期164-166,170,F0003,共5页Journal of China-Japan Friendship Hospital

摘　　要：目的:观察特发性黄斑前膜(IERM)的三维频域光学相干断层扫描(SD-OCT)图像的形态特征,探讨IERM对视力的影响。方法:经视力、直间接眼底镜及SD-OCT(二维断面图、眼底彩色照相、视网膜厚度地形图、三维成像图)检查确诊的IERM患者38例(45只眼),分析中心凹形态、中心凹厚度和最佳矫正视力的关系。结果:IERM的SD-OCT图像表现为视网膜表面薄厚不一的高反光带,绝大多数伴程度不同的中心凹厚度增加。45只眼中,中心凹正常型8只(17.8%),假性黄斑裂孔6只(13.3%),板层裂孔7只(15.6%),弥漫水肿20只(44.4%),囊样水肿4只(8.9%)。对全部患眼最佳矫正视力与黄斑中心凹厚度进行相关分析,二者显著负相关(r=-0.37,P<0.05),即黄斑中心凹越厚视力越差。结论:SD-OCT可明确IERM的诊断和其下中心凹形态的分型,由IERM牵拉引起的黄斑水肿增厚与视力损害相关。Objective：To evaluate macular morphological changes of idiopathic epiretinal membrane （IERM） with spectral domain optical coherence tomography （SD-OCT）and analyze influence of macular thickness on best corrected visual acuity （BCVA）.Methods：Thirty eight cases （45 eyes）in the hospital were diagnosed as IERM with VA examination,direct and indirect ophthalmoscope.SD-OCT scanning （retinal tomography,color fundus photography,retinal topography,three-dimensional reconstructed image）were performed on all patients and parameters of macular image were analyzed.The relationship between SD-OCT results and BCVA was evaluated.Results：IERM showed varied reflection bend on inner surface of retina with SD-OCT in different patients.Most cases were accompanied with increased foveal thickness.Macular foveal morphological changes were categorized into various types including normal,macular pseudohole（MPH）,lamellar macular hole（LMH）, diffuse edema（DE）and cystic edema（CE）.Eight out of 45 eyes were found with normal fovea（17.8%）,6 eyes with MPH（13.3%）,7 eyes with LMH（15.6%）,20 eyes with DE（44.4%） and 4 eyes with CE （8.9%）.Negative correlation between BCVA and thickness of fovea（r=-0.37,P0.05）was observed.BCVA decreased with increase of foveal thickness.Conclusion：SD-OCT scanning is critical for IERM diagnosis and classification of foveal morphological changes.Categorization of those changes may be important for predicting prognosis in IERM patients.Foveal edema caused by IERM associates with vision loss.

关 键 词：三维光学相干断层扫描 特发性黄斑前膜 中心凹 视力 

分 类 号：R774.1[医药卫生—眼科]