术中OCT在眼底手术中的应用  

Application of intraoperative OCT in fundus surgery

作　　者：代照枝(综述) 李拓(审校) Dai Zhaozhi;Li Tuo(Department of Ophthalmology,The Central Hospital of Enshi Tujia and Miao Autonomous Perfecture,Enshi 445000,China)

机构地区：[1]恩施土家族苗族自治州中心医院眼科,恩施445000

出　　处：《中华实验眼科杂志》2023年第9期944-948,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目(81360154)。

摘　　要：光学相干断层扫描(OCT)是一种光学诊断技术, 可对活体眼组织的显微结构进行非接触、非侵入性断层成像。但因检查过程中需要患者呈坐位状态的配合, 限制了OCT在婴幼儿和卧位患者中的应用。术中OCT(iOCT)可用于卧位患者, 为术者提供术中实时解剖结构和细微病变等关键信息, 有效提高手术的成功率及安全性。目前临床上应用的iOCT类型包括手持iOCT、显微镜下悬吊式iOCT、集成显微镜iOCT等, 其中以集成显微镜iOCT应用最为广泛。iOCT用于多种眼底手术过程中, 在视网膜疾病手术中可用于视网膜脱离复位术、增生性糖尿病视网膜病变切除术等, 在黄斑部手术中可用于黄斑裂孔修复术、黄斑前膜剥除术等, 可有效减少手术并发症、辅助发现亚临床病变、帮助术者做出最合适的术中手术决策、预测患者预后等作用。本文就iOCT的分类和优劣及在视网膜脱离、糖尿病视网膜病变、黄斑前膜及黄斑裂孔等眼底病中的应用进展作一综述, 为广大临床工作者提供参考。Optical coherence tomography(OCT)is an optical diagnostic technique that provides non-contact,non-invasive tomographic imaging of microscopic structures of living ocular tissues.However,it requires the patient to be seated during the examination,which limits its use in infants and recumbent patients.Intraoperative OCT(iOCT)can be used in patients in the decubitus position to provide the surgeon with critical real-time information on anatomy and subtle lesions,improving the success and safety of the procedure.At present,the clinically applied iOCT types include handheld OCT,microscope-mounted OCT,microscope-integrated OCT and so on,among which integrated microscope-integrated OCT is the most widely used.iOCT is mainly used in a variety of fundus surgeries,retinal detachment reduction and proliferative diabetic retinopathy resection in retinal disease surgeries,and macular hole repair and anterior macular membrane stripping in macular surgery.During surgery,the use of iOCT can play a role in reducing surgical complications,detecting subclinical lesions,helping the surgeon make the most appropriate surgical decision,and predicting patient prognosis.This article reviewed the classifications of iOCT,as well as its advantages and disadvantages in the application of retinal detachment,diabetic retinopathy,macular epiretinal membrane,macular hole and other diseases to provide a reference for clinical practitioners.

关 键 词：光学相干断层扫描 术中光相干断层扫描 玻璃体视网膜病变 

分 类 号：R779.6[医药卫生—眼科]