共焦激光视网膜断层扫描在老年性黄斑变性检查中的应用

The application of confocal scanning laser tomography in age-related macular degeneration

目的 观察共焦激光视网膜断层扫描在老年性黄斑变性 (agedrelated macular degeneration,AMD)检查中的应用价值。 方法 应用德国海德堡共焦激光视网膜断层扫描仪 (Heidelberg retinatomo-graph,HRT)对 5 9例 AMD患者的 75只眼进行测量。其中渗出型 AMD患者 2 0例 2 5只眼、萎缩型 AMD患者16例 2 5只眼、AMD玻璃疣患者 2 3例 2 5只眼。对比分析其扫描图像的 Z轴面信号宽度、容积、最大深度的异同。 结果 渗出型 AMD患眼黄斑部的 Z轴面信号的宽度显著增宽 ,最大深度及容积大小与玻璃疣患眼比较 ,差异有显著性的意义 (t值分别是 2 .787、4.487及 3.0 5 4,P值分别是 0 .0 0 8、0 .0 0 0及 0 .0 0 4) ;萎缩型 AMD患眼黄斑部的 Z轴面信号的宽度、最大深度及容积大小与玻璃疣患眼比较 ,差异有显著性的意义 (t值分别是2 .172、2 .394及 2 .6 35 ,P值分别是 0 .0 41、0 .0 2 0及 0 .0 15 ) ;渗出型 AMD患眼黄斑部的容积显著大于萎缩型AMD患眼黄斑部容积 (t=4.10 6 ,P=0 )。 结论 渗出型 AMD患眼黄斑部视网膜病变严重 ,HRT能够评价AMD患眼黄斑部视网膜病变的程度并监测其进展。

Objective To verify the applicable significance of confocal scanning laser retinal tomography in age-related macular degeneration (AMD). Methods Heidelberg confocal scanning laser tomography was used to measure 75 eyes of 59 patients with AMD, including 25 eyes of 20 patients with exudative AMD, 25 eyes of 16 patients with atrophic AMD , and 25 eyes of 23 patients with macular drusen. The differences of the width, volume and maximum height of Z profile signal of macula were analyzed. Results Z profile signal width in macular tomography of exudative AMD was wider than that of macular drusen; maximum height and volume in macular tomography of exudative AMD were larger than that of macular drusen (P<0 01); Z profile signal width, maximum height ,and volume in macular tomography of atrophic AMD were wider and larger than that of macular drusen (P<0.05). Macular volume of exudative AMD was obviously larger than that of atrophic AMD (P<0.01). Conclusion Confocal scanning laser tomography may be one of the useful methods for objective evaluation of morphologic change for the development of AMD.