SD-OCT及FFA在白内障术后黄斑囊样水肿研究中的应用  

Evaluation of cystoid macular edema using optical coherence tomography and fundus fluorescein angiography after cataract surgery

作　　者：万敏婕[1,2] 杨先凤[1,2] 

机构地区：[1]三峡大学第一临床医学院 [2]湖北省宜昌市中心人民医院眼科,湖北省宜昌市443003

出　　处：《眼科新进展》2015年第1期55-59,共5页Recent Advances in Ophthalmology

摘　　要：目的探讨谱域光学相干断层扫描(spectral domain optical coherence tomography,SD-OCT)和眼底荧光血管造影(fundus fluorescein angiography,FFA)检测白内障术后黄斑中心凹厚度及黄斑中心凹旁视网膜水肿的情况,指导白内障术后黄斑囊样水肿的诊断及治疗。方法对2012年5月至2013年9月在我院行白内障手术的患者88例(91眼)进行临床观察。术前及术后1周、4周、12周及24周分别进行详细眼底检查,SD-OCT测量黄斑中心凹厚度及黄斑中心凹旁上方、下方、鼻侧、颞侧视网膜厚度。同时运用LogM AR表行最佳矫正视力(best corrected visual acuity,BCVA)检查。术后较术前黄斑中心凹厚度大3个标准偏差表示存在CME,在术后12周行FFA检查。相关资料运用SPSS 17.0进行统计学分析。结果术前患者黄斑中心凹厚度为(254.68±22.04)μm,术后1周、4周、12周、24周黄斑中心凹厚度分别为(264.52±23.27)μm、(262.51±24.64)μm、(267.52±39.14)μm、(263.71±26.58)μm,均较术前增加,差异均有统计学意义(均为P<0.05),增加最明显的是术后12周时(P=0.028),术后12周时颞侧、鼻侧、上方及下方的黄斑中心凹旁视网膜厚度均较术前显著增加(均为P<0.01)。术后1周、4周黄斑中心凹厚度的改变与BCVA无明显相关性,但术后12周、24周时黄斑中心凹厚度的改变与BCVA有显著相关性(均为P=0.00)。术后12周通过FFA检测的黄斑囊样水肿的发生率为3.3%,而通过SD-OCT检测的发生率为5.5%。结论白内障术后患者黄斑区视网膜厚度有明显改变,SD-OCT能准确观察白内障术后早期黄斑区视网膜厚度的增加及黄斑囊样水肿的形态特点。SD-OCT观察白内障术后黄斑囊样水肿的情况与FFA的结果并非完全一致。Objective To investigate the central macular thickness （CMT） and perifoveal macular edema to guide the diagnosis and treatment of cystoid macular edema （CME） after phacoemulsification surgery. Methods Ninety-one eyes of 88 patients who underwent phacoemulsification surgery between May 2012 and September 2013 were included in the study. Ocular fundus examinations and spectral domain optical coherence tomography （SD-OCT） measurements were performed preoperation and at postoperative 1 week,4 weeks, 12 weeks, and 24 weeks. Mean CMT and perffoveal macular thickness in superior, inferior, nasal and temporal quadrants were recorded. Best corrected visual acuity （BCVA） was measured as logMAR units at preoperative and all postoperative visits. CME was defined as three standard deviations （SD） above the preoperative mean CMT in OCT measurements. Fundus fluorescein angiography （FFA） was performed at postoperative 12 weeks. Data were analyzed statistically by SPSS 17. 0. Results The preoperative CMT was （254.68 ± 22.04） μm, which at postoperative 1 week, 4 weeks, 12 weeks, and 24 weeks were （254.52 ± 23.27 ） μm, （252.51 ± 24. 54） μm, （257.52 ± 39.14） μm and （253.71 ± 26. 58 ） μm,respectively,there were sta- tistical differences （ all P 〈 0.05 ）. The most significant increase in CMT was seen at postoperative 12 weeks （P = 0.028 ）. The changes in perffoveal macular thickness measurements in the temporal, nasal, superior and inferior quadrant was statistically significant at postoperative 12 weeks （ all P 〈 0.01 ）. The increase in macular thickness did not correlated with BCVA at postoperative 1 week and 4 weeks, but there was a significant correlation at postoperative 12 weeks and 24 weeks （all P = 0.00）. The incidence of angiographic CME observed by FFA at postoperative 12 weeks was 3.3% , but which observed by SD-OCT was 5.5%. Conclusion Macular thickness changes after uncomplicated phacoemulsification surgery, SD-OCT is helpful in detecting cystoid ab

关 键 词：超声乳化术 黄斑囊样水肿 光学相干断层扫描 眼底荧光血管造影 

分 类 号：R774.5[医药卫生—眼科]