半剂量光动力治疗中心性浆液性脉络膜视网膜病变患者黄斑光相干断层扫描二维和三维图像的定量比较  

Quantitative Comparison Between Two-Dimensional and Three-Dimensional Macular Optical Coherence Tomography in the Central Serous Chorioretinopathy Treated by Photodynamic Therapy with Half Dose

作　　者：李璐[1] 陈长征[1] 冯超[1] 苏钰[1] 郑红梅[1] 许芳[1] 

机构地区：[1]武汉大学人民医院眼科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2011年第1期81-84,142,共5页Medical Journal of Wuhan University

摘　　要：目的:观察中心性浆液性脉络膜视网膜病变(CSC)患者半剂量光动力治疗(PDT)前后黄斑光相干断层扫描(OCT)二维和三维图像的变化特点,比较二维图像中神经上皮层厚度指标和三维图像中神经上皮层容积指标在治疗前后与视力的相关性以及在诊断中的灵敏度和特异性。方法:选取经间接眼底镜、眼底荧光素血管造影(FFA)和OCT确诊的CSC患者19例(20眼),于半剂量PDT前1d与治疗后1月各检查1次视力与黄斑OCT。对检测结果行统计学分析。结果:19例患者半剂量PDT治疗前后,其黄斑OCT视网膜神经上皮层厚度、容积以及视力经配对t检验,差异均有统计学意义(P<0.01)。治疗前患者黄斑OCT视网膜神经上皮层厚度和容积与视力无明显相关性,经半剂量PDT治疗1月后,患者黄斑OCT视网膜神经上皮层厚度、容积与视力的相关系数分别为-0.545(P<0.05)、-0.705(P<0.01)。在比较各参数受试者工作特征(ROC)曲线下面积(AUC)中,治疗前视网膜神经上皮层厚度指标的AUC为0.813(P<0.01),其敏感度为85%,特异性为65%,治疗前视网膜神经上皮层容积指标的AUC为0.914(P<0.01),其敏感度为85%,特异性为100%,治疗后视网膜神经上皮层厚度指标的AUC为0.175(P<0.01),其敏感度为15%,特异性为100%,治疗后视网膜神经上皮层容积指标的AUC为0.594(P>0.05)。结论:半剂量PDT可有效治疗CSC,黄斑OCT视网膜神经上皮层容积变化较厚度变化可更好地反映其病情及治疗效果。Objective： To explore the characteristic of two-dimensional imaging and three-dimensional imaging of macular optical coherence tomography （OCT） in the central serous chorioretinopathy （CSC） treated by photodynamic therapy （PDT） with half dose, and to study the correlation between visual acuity and imaging feature, as well as the sensitivity and specificity of two-dimensional imaging and three-dimensional imaging of macular OCT in diagnosis of CSC. Methods： Twenty eyes of 19 patients with CSC determined by indirect ophthalmoscope, fundus fluorescence angiography （FFA） and OCT were involved in this study. Visual acuity and OCT examination were performed in all subjects before and one month after PDT with half dose. Results： The thickness of retinal neuroepithelial layer in two-dimensional imaging of OCT and the volume of retinal neuroepithelial layer in three-dimensional imaging of OCT were declined significantly in one month after PDT with half dose, meanwhile, visual acuity got notable improving. There was no significant correlation between the thickness and the volume of retinal neuroepithelial layer and visual acuity before PDT in CSC patients, while they had notable correlation in a month after PDT. Before PDT, area under receiver operating characteristics curve （AUC） of the thickness of retinal neuroepithelial layer in two-dimensional imaging of OCT and the volume of retinal neuroepithelial layer in three-dimensional imaging of OCT were respectively 0.818 and 0.914. The sensitivity and the specificity of the former were 85% and 65%, and those of the latter were 85% and 100%. One month after PDT, AUC of the thickness was 0.175, but the other one had no statistical meaning. The sensitivity and the specificity of the thickness were 15% and 100%. Conclusion： PDT with half dose verteporfin might be an effective treatment for CSC. The change of the volume of retinal neuroepithelial layer in three-dimensional imaging of OCT has a better reflection in the illness condition and treatment re

关 键 词：黄斑光相干断层扫描 视网膜神经上皮层厚度 视网膜神经上皮层容积 半剂量光动力治疗 中心性浆液性脉络膜视网膜病变 

分 类 号：R774.1[医药卫生—眼科] R770.43[医药卫生—临床医学]