外层视网膜管状结构的研究进展  

Research progress of outer retinal tabulation

作　　者：李冰[1] 陈有信[1] Li Bing;Chen Youxin(Department of Ophthalmology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院眼科,100730

出　　处：《中华眼科杂志》2020年第2期149-154,共6页Chinese Journal of Ophthalmology

摘　　要：外层视网膜管状结构(ORT)是指在频域相干光层析成像术(SD-OCT)中观察到的位于视网膜外核层的圆形或类圆形、边缘高反射信号而内腔相对低反射信号的异常结构,伴有局部视网膜外界膜中断、卷曲及视网膜色素上皮萎缩。组织病理学研究认为ORT是光感受器细胞和外层视网膜在病理条件下发生的重构,是外层视网膜严重损伤的表现。ORT可见于多种视网膜退行性疾病的终末阶段,在年龄相关性黄斑变性中较为常见,且随着随访时间的延长逐渐增多。ORT在SD-OCT中的形态与视网膜内积液或囊样水肿有一定相似之处,但其并不是新生血管活动和再治疗的依据,且对抗血管内皮生长因子治疗反应不佳,视力预后较差。因此充分认识ORT,对临床开展相关眼底病治疗、判断预后十分重要。本文对目前有关ORT的组织病理学研究及临床研究的进展进行总结,以期为临床工作提供参考。The outer retinal tubular structure(ORT)indicates a round or oval-shaped structure with a highly reflective border and a relatively low reflective lumen on spectrum-domain coherence tomography.ORTs are located in the outer nuclear layer accompanied by disruption and curling of the external limiting membrane and retinal pigment epithelial atrophy.Histopathological researches have revealed that ORTs are some kind of remodeling of the outer retina especially photoreceptors under pathological conditions,representing an advanced damage to the outer retina and a common final pathway of various retinal degenerative diseases.ORTs are common in neovascular age-related macular degeneration.They show some similarities in morphology with inter retinal fluid or cystoid edema on spectrum-domain coherence tomography,but they are not an indication for neovascular activity and retreatment.Their response to anti-vascular endothelial growth factor is poor,and the visual prognosis is not optimistic.Therefore,raising awareness of ORTs is very important for guiding clinical treatment and judging prognosis.

关 键 词：体层摄影术 光学相干 光感受器细胞 视网膜光感受器细胞外节 萎缩 

分 类 号：R774.1[医药卫生—眼科]