特发性视网膜前膜黄斑区时域与频域光相干断层扫描图像特征和定量测量结果比较  

Macular imaging and measurements of idiopathic epiretinal membranes with stratus and spectral-domain optical coherence tomography

作　　者：黄晶晶[1] 刘杏[1] 肖辉[1] 钟毅敏[1] 毛真[1] 

机构地区：[1]中山大学中山眼科中心眼科学国家重点实验室,广州510060

出　　处：《中华眼底病杂志》2012年第4期337-341,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：基金项目：中央高校基本科研业务费中山大学青年教师培育项目（10ykpy26）

摘　　要：目的 比较特发性视网膜前膜（ERM）黄斑区时域光相干断层扫描（OCT）与不同型号频域OCT扫描图像特征及定量测量结果的异同。 方法 2008年8～10月确诊为特发性ERM连续病例（ERM组）46例46只眼纳入研究。患者中，男性11例，女性35例；平均年龄（61.04±10.13）岁。选择同期年龄、性别匹配的正常人21名21只眼作为正常对照组。两组受检者均行时域OCT（Stratus OCT）和频域OCT（Cirrus OCT、3D OCT-1000）检查。将黄斑部划分为3个同心圆，分别为直径1 mm的中央区，1 mm＜直径≤3 mm的内环区，3 mm＜直径≤6 mm的外环区。在内外环分别有2 条放射线分为上、鼻、下、颞4区，共9个区。比较不同OCT视网膜成像和3种仪器测量值的差异及其相关性、正常对照组与ERM组黄斑区视网膜厚度的差异。并对ERM组黄斑区视网膜厚度与视力的相关性进行分析。结果 时域OCT和频域OCT均可见ERM组患者黄斑区视网膜增厚，视网膜内层结构紊乱，内表面凹凸不平，内、外丛状层增生。但频域OCT对视网膜内层结构及视网膜内表面增生膜的细微病理改变显示更清晰。所有受检者黄斑区视网膜厚度，Cirrus OCT和3D OCT-1000测量值均较Stratus OCT测量值高，Cirrus OCT测量值较3D OCT-1000测量值高，差异有统计学意义（t=7.445~11.253，P=0.000）；3种OCT仪测量的各参数相关性良好，相关系数均大于0.9。3种OCT扫描结果均显示，ERM组黄斑中心凹凹陷变浅或消失，黄斑不同区域视网膜厚度均较正常对照组增厚，以黄斑区3 mm内环区增厚最明显，差异有统计学意义（t=2.477~10.139, P＜0.05）。ERM组3种OCT仪测量的黄斑各区域视网膜厚度与视力呈中度负相关（r=-0.216^-0.517）。结论 频域OCT成像较时域OCT更清晰、精细；时域OCT与频域OCT测量值相关性较好。但并不相同，不能相互替代。Objective To compare the macular imaging and measurements of patients with idiopathic epiretinal membranes （ERM） by stratus optical coherence tomography （OCT） and two different types of spectral-domain OCT. Methods Forty-six consecutive patients （46 eyes） diagnosed as idiopathic ERM in the period of August 2008 to October 2008 were enrolled in this study. The patients included 11 males and 35 females, with a mean age of （61.04±10.13） years. Twenty-one age- and sex- matched normal subjects （21 eyes） were enrolled in this study as control group. All the subjects underwent stratus OCT, cirrus OCT and 3D OCT-1000 examinations. The macular area was divided into three concentric circles which including central region with 1 mm diameter, inner area with 〉1 mm but ≤3 mm diameter, and outer ring area with 〉3 mm but ≤6 mm diameter. The inner area and outer ring area were divided into superior, nasal, inferior and temporal quadrants by two radioactive rays. The characteristics of OCT images and the quantitative measurements were compared among these three machines. The macular thickness of ERM group and control group was also compared. And the correlation of visual acuity and the macular thickness in idiopathic ERM patients was evaluated. Results The increased macular retinal thickness, disorder structure of inner retina, uneven surface and proliferative inner and outer plexiform layer were observed in ERM group by stratus and spectral-domain OCT. But the minor pathological changes on inner retina structure and internal surface proliferation could be observed more clearly by spectral-domain OCT than those by stratus OCT.The macular thicknesses of all the subjects measured by Cirrus OCT and 3D OCT-1000 were thicker than those measured by Stratus OCT （t=7.445-11.253,P=0.000）. The correlations of measurements between three OCTs were good （r〉0.9）. The flatted or disappeared fovea of ERM patient group was observed by all three OCTs. The macular thicknesses on different subfields of patients

关 键 词：视网膜外膜/诊断 体层摄影术 光学相干 诊断显像 

分 类 号：R774.5[医药卫生—眼科]