OCT_3和FFA结合对钝挫伤引起的黄斑水肿的分析研究  

Analysis and Research of the combination of OCT_3 and FFA about Macular Edema Caused by Blunt Trauma

作　　者：段惠静[1,2] 刘平[1] 黎国英[2] 徐瑶[2] 张晶旭[2] 黄德磊[2] 傅宏[2] 

机构地区：[1]哈尔滨医科大学附属一院眼科,黑龙江哈尔滨150001 [2]大庆龙南医院

出　　处：《中国伤残医学》2010年第4期31-34,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:定性定量全面准确分析钝挫伤引起的黄斑水肿,以期早期发现黄斑水肿、明确诊断、对症治疗。方法:对42例50眼拟诊为黄斑水肿患者在同1天分别由同1名操作熟练的医生分别进行Zeiss-Visucam型眼底荧光造影仪和Zeiss-Stratus-TM-3000型光学相干断层扫描仪检查,观察造影显影情况、分析总结扫描图像特征,计算出黄斑中心凹平均厚度值。结果:经FFA检查可见荧光渗漏者13眼(26%),可见透见荧光者16眼(32%),荧光无异常者21眼(42%);用OCT3检查黄斑中心凹厚度增厚者37眼(74%),变薄者3眼(6%),厚度在正常范围者10眼(20%);黄斑厚度地形图颜色区域数值显示40眼有黄斑水肿,相应图像特征总结:神经上皮层不光滑、结构紊乱者16眼占40%,神经上皮层间水肿10眼占25%,神经上皮浆液性脱离4眼占10%,网膜增厚、结构无明显变化10眼占25%,黄斑中心凹平均厚度值296±30um。结论:对于诊断钝挫伤引起的黄斑水肿,OCT检查敏感性高于FFA,只有OCT3与FFA检查相互印证,取长补短,才能定性定量全面准确评估黄斑水肿的发生、发展及愈后。Objective：A comprehensive and accurate qualitative and quantitative analysis of macular edema caused by blunt trauma is need in order to detect macular edema early and make a clear diagnosis and symptomatic treatment.Methods：On the same day,one skilled doctor made separately Zeiss-Visucam type fundus fluorescein angiography instrument and Zeiss-Stratus-TM-3000-based optical coherence tomography examination for 42 cases of 50 eyes patients to be diagnosed as macular edema,observed the results,analyze the scanned image features and calculated the average foveal thickness.Results：The FFA examination showed leakage in 13 eyes（26%）,showing that penetration see the fluorescence was detected in 16 eyes（32%）,without abnormal fluorescence in 21 eyes（42%）;the OCT3 examination of foveal thickness showed thickening 37（74%）,thinning in 3 eyes（6%）,the normal thickness 10 eyes（20%）;the color regions value of macular thickness topography showed that 40 eyes had macular edema,the corresponding image features summarized：16eyes（40%）nerve epithelium is not smooth,structural disorders;10 eyes（25%）edema between nerve epithelium,4 eyes（10%）serous neuroepithelial detachment,10 eyes（25%）retinal thickness thickening,no significant structural change.The average thickness value of macular foveal is 296 ± 30um.Conclusion：For the diagnosis of macular edema caused by blunt trauma,OCT examination was more sensitive than FFA.Only analyzing the results of OCT3 and FFA examination,can we assess the occurrence,development and prognosis of macular edema accuratly and comprehensivly,qualitatively and quantitatively.

关 键 词：钝挫伤 黄斑水肿 三代光学相干断层扫描(OCT3) 眼底荧光造影(FFA) 

分 类 号：R828.7[医药卫生—临床医学]