激光扫描共焦检眼镜对黄斑囊样水肿成像的定量分析  

Imaging performance and quantitative analysis of confocal scanning laser ophthalmoscope for cystoid macular edema

作　　者：霍妍佼[1] 杨丽红[1] 魏文斌[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室,100730

出　　处：《中华实验眼科杂志》2017年第1期53-57,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目（81272981）;北京市自然科学基金项目（7151003、7112031）;北京市医院管理局临床医学发展专项经费（ZYLX201307）;首都医科大学附属北京同仁医院科研基金项目（2015-YJJ-ZZL-011）

摘　　要：背景黄斑囊样水肿（CME）可由多种眼底疾病导致，目前主要的无创临床诊断方法为彩色眼底照相和频域OCT（SD—OCT），OCT对于CME的断层形态和定量分析较好，但是对水肿的范围评价欠佳。基于激光扫描共焦检眼镜（cSLO）的视网膜成像技术对组织穿透性好，分辨率高，采集的眼底像清晰，对比度好，但是对于CME的检测价值尚不清楚。目的评价cSLO视网膜成像技术对CME定性和定量分析的临床价值。方法采用描述性研究方法，于2015年8—12月在北京同仁医院眼科中心确诊的CME患者24例24眼，采用cSLO视网膜成像技术对黄斑区进行放射状扫描和线扫（45°×45°，49个水平扫描），分别获得伪彩成像、绿光（532nm）反射成像和红外光（785nm）反射成像，应用EasyScan软件（1．2．2版）进行图像分析，并用传统彩色眼底照相技术和SD—OCT对患眼眼底进行成像，由专业的眼底病医师对每个图像的清晰度进行分级，并依CME图像和边界的清晰度进行评分。结果本组患者CME的原发病包括黄斑前膜（ERM）10例10眼、视网膜分支静脉阻塞（BRVO）6例6眼、视网膜中央静脉阻塞（CRVO）4例4眼、糖尿病视网膜病变（DR）3例3眼和CRVO合并BRVO1例1眼。传统彩色眼底照相可显示CME像，但边界不清；cSLO视网膜成像可见明显的CME范围，边界清晰。CME区cSLO视网膜成像的伪彩成像、IR反射像和绿光反射像清晰度平均评分分别为3．21±0．78、2．67±0．96和2．54±0．83，均明显高于传统彩色眼底照相的1．33±0．82，差异均有统计学意义（均P〈0．01）。结论cSLO视网膜成像技术对CME的成像质量明显优于传统彩色眼底照相，结合SD-OCT断层扫描图像可以为CME的诊断和病情监测提供更加全面的信息。Background Cystoid macular edema （CME） is caused by many fundus diseases. The noninvasive clinical diagnosis methods for CME are conventional color fundus photography up to now. However,these images can not display the CME range well. Confocal scanning laser ophthalmoscope （cSLO） based retinal imaging can provide clear picture with high contrast. However,whether cSLO imaging is feasible in the quantitative assessment of CME remains unclear. Objective This study was to image the boundary of CME and assess the quantification of CME image from cSLO imaging technology. Methods A series case-observational study was designed. This study protocal was approved by Ethic Committee of Beijing Tongren Hospital. cSLO based retinal imaging technology was carried out on consecutive 24 eyes of 24 patients with clinically diagnosed and OCT confirmed CME in Beijing Tongren Eye Center from August to December 2015 under the informed consent of each individual. The radial scan range was 45°× 45° and the line scan level was 49 at macula area. The pseudocolar image, green light reflective image （532 rim） and infrared reflective image （785 nm） were collected. The imaging was analyzed by EasyScan software （version 1.2.2）. Fundus color photography and SD-OCT were carried out in each patient. The images were graded by specialists according to the SD-OCT cross sectional results. Results The primary causes of CME included epiretinal membrane （ 10 eyes）, branch retinal vein occlusion （ BRVO ） （6 eyes）, central retinal vein occlusion （CRVO） （4 eyes） ,dlabetic retinopathy （DR） （3 eyes） and CRVO with BRVO （1 eye）. A CME image was exhibited on the fundus color photogram with the obscure boundary;while the clear range of CME was displayed by the cSLO imaging. The mean score of CME from pseudocolar image, green light reflective image and infrared reflective image was 3.21±0.78,2.67±0. 96 and 2.54±0. 83, respectively, which was significantly higher than 1.33 ±0. 82 from the fundus color phot

关 键 词：计算机辅助成像系统 眼科诊断技术 激光 视网膜成像 检眼镜检查 囊样黄斑水肿/ 诊断 光学相干断层扫描 激光扫描共焦检眼镜/方法 

分 类 号：R774.5[医药卫生—眼科]