光学与超声生物测量在观察玻璃体积血及视网膜脱离患眼视轴长度中的应用  

Comparison of axial length using optical and ultrasonic biometry in the observation of eyes with vitreous hemorrhage and retinal detachment

作　　者：李岩[1] 刘洋辰[1] 邓美玉 王琦妙 武斌[1] 高建民[1] 张楠[1] 刘冬[1] 刘学一 Li Yan;Liu Yangchen;Deng Meiyu;Wang Qimiao;Wu Bin;Gao Jianmin;Zhang Nan;Liu Dong;Liu Xueyi(Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmologyand Visual Science, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China)

机构地区：[1]天津市眼科医院天津市眼科学与视觉科学重点实验室天津医科大学眼科临床学院,300020

出　　处：《中华医学超声杂志（电子版）》2017年第10期738-742,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：天津市卫生科技基金重点项目(2015KR05)

摘　　要：目的比较光学与超声生物测量在观察玻璃体积血及视网膜脱离患眼视轴长度中的应用。方法选取2016年5月1日至5月31日在天津市眼科医院确诊为玻璃体积血和(或)视网膜脱离的57例患者(共57只眼),患眼均未接受过眼部手术,否认眼部外伤史,排除其他眼部疾病。患眼中各种病因引起的玻璃体积血25只眼,视网膜脱离24只眼,视网膜脱离合并玻璃体积血8只眼。术前24 h内为患眼分别采用Lenstar LS 900光学生物测量、浸润式B型超声(IB)及浸润式A型超声(IA)行超声生物测量以分别获取视轴长度。采用配对样本t检验对所获取视轴长度结果进行对比分析。结果全部57只患眼均可获取IB及IA数据,测量结果显示IB与IA比较,差异均无统计学意义(P均>0.05);全部57只患眼中,有36只患眼因严重屈光间质混浊无法获取Lenstar数据,测量结果显示IB与IA比较,差异无统计学意义(P>0.05);其余21只患眼均可获取3组测量结果:IB大于Lenstar[(24.057±1.441)mm vs(23.470±1.775)mm],差异有统计学意义(t=3.099,P<0.05);IA大于Lenstar[(23.962±1.443)mm vs(23.470±1.775)mm],差异有统计学意义(t=2.643,P<0.05);IB与IA比较,差异无统计学意义(P>0.05)。结论在玻璃体积血和(或)视网膜脱离患眼中,光学生物测量由于受到异常屈光间质状态的影响,存在视轴长度无法测量或测量结果偏差的情况,在此情况下应选择IA或IB作为优选测量手段以保障视轴长度结果的准确性。Objective To compare the applied signification of optical and ultrasonic biometry in observing the axial length of eyes with vitreous hemorrhage and retinal detachment.MethodsThis is a prospective clinical study.We randomly selected57cases(57eyes)with vitreous hemorrhage and(or)retinal detachment from May1,2016to May31.Patients had not been performed eye surgery,also denied the history of ocular trauma and excluded other eye diseases.25eyes with vitreous hemorrhage,24eyes with retinal detachment,8eyes complicated with vitreous and retinal detachment hemorrhage.At24hours before surgery,we measured axial length using the Lenstar LS900,immersion B-ultrasound(IB)and immersion A-ultrasound(IA).The differences between three methods were assessed with paired sample t-test.Results IB and IA data was collected from all57eyes,there was no statistical significance between measurements of IB and IA(P>0.05).In the eyes with serious refractive medium opacity(36eyes),the results showed no statistical significance difference between measurements of IB and IA(P>0.05).The measurements of three groups can be obtained from the rest eyes(21eyes):significant statistical difference of the measurements between IB and Lenstar was detected[(24.057±1.441)mm vs(23.470±1.775)mm],(t=3.099,P<0.05)same results between IA and Lenstar was obtained[(23.962±1.443)mm vs(23.470±1.775)mm],difference was statistically significant(t=2.643,P<0.05).But the measurements showed no statistical significance difference between the measurements of IB and IA(P>0.05).Conclusions In the eyes with vitreous hemorrhage and(or)retinal detachment,the measurements of axial length could not be achieved or existed deviations on account of refractive medium opacity when using optical biometry.Under such circumstances,we should choose IA or IB as the optimization method to obtain measurements,in order to get much more accurate results.

关 键 词：超声检查 玻璃体出血 视网膜脱离 生物测量学 

分 类 号：R445.1[医药卫生—影像医学与核医学] R774.12[医药卫生—诊断学]