光学相干断层扫描联合间接检眼镜检查对白内障患者术前眼底评估的优势  

Combination of optical coherence tomography with indirect ophthalmoscope to enforce the fundus evaluation before the operation of age-related cataract

作　　者：王静波[1] 盛豫[1] 赵娜[1] 关娟[1] 

机构地区：[1]解放军第309医院眼科,北京100091

出　　处：《中国老年学杂志》2012年第20期4363-4364,共2页Chinese Journal of Gerontology

基　　金：国家自然科学基金项目(81100684)

摘　　要：目的探讨光学相干断层扫描(OCT)联合间接检眼镜检查对白内障患者进行术前眼底评估的优势。方法通过OCT对黄斑区进行扫描,再联合间接检眼镜检查对年龄相关性白内障患者进行术前眼底检查。结果 126例(180眼)白内障患者中,112例(132眼,73.3%)患者可通过OCT来检查黄斑区视网膜结构,89例(108眼,60.0%)患者可通过间接检眼镜来观察眼底,二者差异显著(χ2=7.20,P=0.007)。通过OCT检查发现的黄斑区异常有27例(30眼),主要包括视网膜出血、玻璃膜疣、黄斑水肿、色素上皮脱离和视网膜前膜等。通过间接检眼镜检查发现的黄斑区异常有23例(25眼),主要包括视网膜出血、玻璃膜疣、硬性和软性渗出、视网膜前膜等。结论通过OCT的检查,可清晰地观察视网膜(包括部分脉络膜)各层的细微结构,但其无法对整个眼底进行平面形态学观察,而间接检眼镜检查则可弥补OCT的这一缺陷。通过OCT联合间接检眼镜检查,可对大多数年龄相关性白内障患者在术前进行详细准确的眼底检查,可及早发现并诊断眼底病变,为术后视力的预测提供详实的客观依据。Objective To detect the advantages of fundus evaluation by optical coherence tomography （OCT） and indirect ophthal moscope before cataract surgery. Methods By the combination of OCT and indirect ophthalmoscope, fundus of patients with age-related cat aract were examined. Rest!Its 126 patients （180 eyes） with cataract were enrolled. Macular retinal microstructure of 112 patients （132 eyes, 73.3% ） could be detected by OCT, and fundus of 89 patients （ 108 eyes, 60.0% ） could be examined by indirect ophthalmoscope, and difference of the two methods was significant （X2 = 7.20,P = 0. 007）. By OCT, macular diseases were detected in 27 cases （30 eyes）, including retinal hemorrhage, drusen, macular edema, detachment of retinal pigment epithelium and epiretinal membrane, etc. By indirect ophthalmoscope, macular diseases were detected in 23 cases （25 eyes）, including retinal hemorrhage, drusen, hard and soft exudates, and epiretinal membrane, etc, Conclusions By OCT, the fine structure of every retinal layer （ including some part of choroid） can be observed clearly. However, the fundus can not be examined from the view of fiat shape,, which can be remedied by indirect ophthalmoscope. By the examination of OCT and indirect ophthalmoscope, fundus can he examined thoroughly and accurately for patients with cataract before opera- tion, and fundus diseases can be discovered early, which can provide detailed and objective basis for the prediction of post-operative vision.

关 键 词：白内障 光学相干断层扫描 间接检眼镜 黄斑 

分 类 号：R776[医药卫生—眼科]