广角激光检眼镜对视网膜脱离的评价

Diagnostic value of panoramic scanning laser ophthalmoscope for retinal detachment

目的利用免散瞳广角激光检眼镜(全景200检眼镜)获取眼图像,评价单独通过全景200眼底图像对视网膜脱离作出诊断的准确性。方法利用全景200广角激光检眼镜获取眼底图像,观察其与临床医师散瞳双目间接检眼镜检查结果是否相符,眼底情况包括视网膜脱离范围、有无裂孔和(或)增生,并对不符合的病例作出分析。结果分析用广角激光检眼镜获取的71例视网膜脱离患者75只眼的眼底图像,其中3例3只眼复发性视网膜脱离。单纯视网膜脱离者13例16只眼(伴视网膜囊肿1例1只眼),伴裂孔者43例43只眼,伴视网膜前或视网膜下增生者14例15只眼(4只眼同时伴有裂孔)。与临床医师散瞳检查结果符合的有53例56只眼,不符合18例19只眼,不符合者主要表现为全景200图像对周边小裂孔的遗漏。16例手术后复查者与临床记录均符合。结论全景200广角激光检眼镜具有免散瞳、快速、大范围眼底视野等优点,可保存客观记录,提供高分辨率的图像,对视网膜脱离有较高的诊断价值。

Objective To evaluate the diagnostic value of panoramic 200 scanning laser ophthalmoscope for retinal detachment. Method Images of ocular fundus of the patients with retinal detachment were obtained by panoramic 200 scanning laser ophthalmoscopy, which were compared with the results of binocular indirect ophthalmoscopy （BIO）. The extent of the retinal detachment, the occurrence of retinal hole or not, and the proliferation were observed. Any discrepancies of the results of the two methods were then analyzed. Results In the images from 75 eyes of 71 patients with retinal detachments which were obtained by panoramic 200 scanning laser ophthalmoscopy, recurrent retinal detachments was found in 3 patients （3 eyes）, single retinal detachment was in 13 patients （16 eyes） including intercurrent retinal cyst in 1 patient （1 eye）, intercurrent retinal hole was in 43 patients （43 eyes）, and intercurrent pre- or sub-retinal proliferation was in 14 patients （15 eyes） （4 eyes having retinal hole simultaneously）. The results of panoramic 200 scanning laser ophthalmoscopy and BIO were accordant in 53 patients （56 eyes） and inconsistent in 18 patients （19 eyes） due to the loss of peripheral small retinal holes by panoramic 200 scanning laser ophthalmoscopy. The results of the follow up examination of 16 patients were accordant with the clinical records. Conclusion Panoramic 200 scanning laser ophthalmoscope has the advantages of non mydriasis, speediness, and wide view field, and can save external records and provide high-resolution images; it is a valuable diagnosis method for retinal detachment.