糖皮质激素治疗原田氏病的早期光学相关断层成像变化  

Early optical coherence tomography changes after the corticosteroid therapy for Vogt-Koyanagi-Harada Disease

作　　者：赵桂玲 庞燕华 周舟 黎宗汉 聂利娇 ZHAO Gui-ling;PANG Yan-hua;ZHOU Zhou;LI Zhong-han;NIE Li-jiao(Department of Ophthalmology,the Affiliated Hospital of Guangdong Medical University,Zhanjiang 524023,China)

机构地区：[1]广东医科大学附属医院眼科,广东湛江524023

出　　处：《广东医科大学学报》2018年第2期176-179,共4页Journal of Guangdong Medical University

摘　　要：目的分析糖皮质激素治疗原田氏病(VKH)早期光学相关断层成像(OCT)的变化。方法对临床确诊的20例(39只眼)VKH患者进行糖皮质激素治疗前后早期黄斑区的OCT检查,并分析其图像特点。结果患者治疗后平均log MAR视力明显高于治疗前[(1.06±0.57)vs(0.34±0.21)],黄斑厚度则低于治疗前[(332±152)μm vs(667±312)μm],差异均有统计学意义(P<0.01)。治疗前38只眼出现渗出性视网膜脱离(ERD),38只眼视网膜神经上皮水肿,26只眼出现脱离区域内的膜样结构,27只眼出现视网膜色素上皮层皱褶(RPE)。治疗后10只眼的ERD完全消失,12只眼的视网膜神经上皮水肿消退,但新增了1只眼发生神经上皮水肿。22只眼的脱离区内膜样结构消失,18只眼RPE消失,但2只眼出现了RPE。结论 OCT有助于及时了解糖皮质激素治疗VKH过程中患者病情的变化,以便进行药物调整。Objective To analyze early optical coherence tomography（OCT） changes after the corticosteroid therapy for Vogt-Koyanagi-Harada Disease（VKH）. Methods The OCT image of VKH patients before and after the corticosteroid therapy were analyzed. Results After the treatment, the patients had an average log MAR visual acuity significantly higher than that before the treatment [（1.06±0.57） vs（0.34±0.21）], and the macular thickness lower than that before the treatment[（332±152） μm vs（667±312） μm], and the difference was statistically significant（P〈0.01）. Before the treatment, 38 eyes had exudative retinal detachment（ERD）, 38 eyes had retinal neuroepithe-lial edema, 26 eyes had membrane structure（MS）,and 27 eyes had RPE fold. After corticosteroid therapy for 7-15 days, 10 eyes had the ERD completely disappeared, 12 eyes had the retinal neuroepithelial edema gradually vanished, but another eye had neuroepithelial edema. 22 eyes had the MS disappeared, 18 eyes had RPE disappeared, but another 2 eyes had RPE. Conclusion OCT helps to timely understand the changes in the disease situation of the patients during the corticosteroid therapy for Vogt–Koyanagi–Harada disease so as to make drug adjustment.

关 键 词：小柳原田氏病 光学相干断层成像 糖皮质激素 

分 类 号：R816[医药卫生—放射医学]