老年性白内障在超声生物显微镜诊断中的特征

A Study of Ultrasound Biomicroscope in Diagnoses of Senile Cataract

目的:研究各期老年性白内障的超声生物显微镜(ultrasoundbiomicroscope,UBM)影像学特征,探讨UBM用于老年性白内障诊断的可行性。方法:对裂隙灯显微镜诊断为老年性白内障的80只眼(其中初发期,膨胀期,成熟期,过熟期各20只眼)行UBM检查,并对UBM检查结果进行影像学特征分析。结果:各期老年性白内障的UBM图像有其特有的影像特点。初发期白内障表现为晶状体赤道部散在小片状的高回声区。膨胀期白内障表现为晶状体内片状高回声区与低回声区相交错,同时可见到晶状体赤道部增厚。成熟期白内障表现为晶状体皮质呈较均匀的高回声,有时晶状体核处可见更高回声。过熟期白内障则表现为晶状体前囊不均匀增厚,回声增强,晶状体呈不规则回声(不均匀高密度反光),前房内有时可见特征性高回声颗粒,可阻塞房角。结论:超声生物显微镜可作为老年性白内障的一种辅助诊断手段,特别适用于眼前段屈光介质混浊或小瞳孔者。

Purpose：To investigate the imaging characteristics of ultrasound biomicroscope （UBM） in the different stages and evaluate preliminary application of UBM in diagnosis of senile cataract.Methods： Using UBM to examine 80 eyes, which were diagnosed senile cataract by slit-lamp microscope （20 eyes, incipient stage; 20 eyes, intumescent stage; 20 eyes, mature stage ; 20 eyes, hypermature stage）.Results ： The UBM image of senile cataract is distinguished in the different stages. In incipient stage, it shows sporadic flake high echo areas in equator of the lens. In intumescent stage, it shows flake high echo areas and low echo areas interlace each other, and the thickness of equator increases. In mature stage, it shows symmetrical high echo areas in cortex of the lens and higher echo areas in nucleus of the lens sometimes. In hypermature stage, it shows irregular echo （heterogeneous high density glisten） areas of the lens, heterogeneous incrassation and strong echo areas of anterior capsule.Characteristic high echo granules were found in the anterior chamber. The granules may obstruct the anterior chamber angle.Conclusion ：The UBM examination can be an assistant diagnostic method for senile cataract, especially for the patients whose refractive media of ocular anterior segment is opacity or the pupil is very small. Eye Science 2005;21：116-119.