手术中光相干断层扫描下周边视网膜病变  

Peripheral retinopathy under intraoperative optical coherence tomography

作　　者：王文战[1] 宋德弓 李龙[1] 邓先明[1] 石径 Wang Wenzhan;Song Degong;Li Long;Deng Xianming;Shi Jing(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科,河南省眼科医院,郑州450052

出　　处：《中华眼底病杂志》2023年第4期318-323,共6页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察手术中光相干断层扫描(iOCT)下的周边视网膜病变组织病理改变。方法回顾性病例系列研究。2021年10月至2022年5月于郑州大学第一附属医院东院区眼科行玻璃体视网膜手术患者88例94只眼纳入研究。其中,男性49例,女性39例;年龄(50.93±17.55)岁。94只眼中,视网膜脱离32只眼;增生型糖尿病视网膜病变6只眼;玻璃体积血28只眼;眼外伤8只眼;黄斑病变14只眼;葡萄膜炎1只眼;家族性渗出性玻璃体视网膜病变(FEVR)1只眼;急性视网膜坏死(ARN)1只眼;晶状体脱位3只眼。所有患眼玻璃体视网膜手术中均行iOCT检查。周边扫描时辅以巩膜外顶压,依据不同眼底疾病特点,对赤道前及锯齿缘前后视网膜进行扫描。记录各种异常的眼底表现。结果94只眼中,周边视网膜存在不同类型视网膜病变53只眼(56.38%,53/94)。其中,视网膜囊样变性7只眼(7.45%);格子样变性19只眼(20.21%);色素变性8只眼(占8.51%);“铺路石样”变性9只眼(9.57%);细小隐蔽性裂孔7只眼(7.45%);FEVR锯齿缘“堤坝样”增生变性1只眼(1.06%);玻璃体和视网膜病变粘附4只眼(4.26%);ARN1只眼(1.06%)。结论屈光间质清晰情况下,iOCT对不同周边视网膜病变均能清晰扫描。Objectivee To observe the histopathological changes in peripheral retinal lesions under intraoperative optical coherence tomography(iOCT).Methods A retrospective case series study.Eighty-eight patients(194 eyes)who underwent vitreoretinal surgery in the Department of Ophthalmology at the East Ward of the First Affiliated Hospital of Zhengzhou University from October 2021 to May 2022 in 94 eyes were included in the study.Among them,49 cases were male and 39 cases were female,with the mean age of(50.93±17.55)years.Ninety-four eyes included 32 eyes with retinal detachment,6 eyes with proliferative diabetic retinopathy,28 eyes with vitreous hemorrhage,8 eyes with ocular trauma,14 eyes with the macular lesion,1 eye with uveitis,1 eye with family exudative vitreoretinopathy(FEVR),1 eye with acute retinal necrosis(ARN),and 3 eyes with lens dislocation.All affected eyes were examined with iOCT during vitreoretinal surgery.The iOCT scanning of the peripheral retina was performed with the help of episcleral pressure.The pre-equatorial and serrated edge anterior and posterior of retinas were scanned according to the characteristics of different fundus diseases.Various abnormal fundus manifestations were recorded.Results In 94 eyes,53 eyes(56.38%,53/94)have different types of retinopathy in the peripheral retina.Of these,7 eyes(7.45%)have retinal cystoid degeneration;19 eyes(20.21%)have lattice degeneration;and 8 eyes(8.51%)have pigment degeneration;9 eyes(9.57%)have pavement-like degeneration;7 eyes(7.45%)have small occult holes;1 eye(1.06%)has familial exudative vitreoretinopathy(FEVR)serrated edge"dyke-like"proliferative degeneration;4 eyes(4.26%)have vitreous and retinopathy adhesions;and one eye(1.06%)has ARN.Conclusion With clear refractive media,iOCT can provide clear scans of different peripheral retinal lesions.

关 键 词：周边视网膜病变 手术中光相干断层扫描 玻璃体视网膜手术 视网膜变性 

分 类 号：R774.1[医药卫生—眼科]