海德堡视网膜断层扫描仪对黄斑疾病的检查分析

Analysis of the Heidelberg Retina Tomograph Ⅱ for the detection of macular diseases

目的观察分析海德堡视网膜断层扫描仪（HRT-Ⅱ）对黄斑疾病的检查应用。设计回顾性病例观察研究。研究对象110例黄斑疾病患者201眼。方法用HRT-Ⅱ的黄斑水肿程序（MEM）检查分析正常眼52只、黄斑水肿眼74只、黄斑裂孔眼23只、黄斑前膜眼31只、老年黄斑变性合并脉络膜新生血管（CNV）眼21只。主要指标水肿指数E和信号宽度W及反射图的形态特征。结果正常眼黄斑部分区域水肿指数E和信号宽度w与年龄呈部分相关（r=-0．207～0．359）。黄斑疾病各组E值和W值与正常组比较均有极显著性差异（P均=0．000），其中，黄斑水肿组差异最大。HRT-Ⅱ的反射图可显示黄斑囊样水肿的囊腔、黄斑裂孔的形态和大小、黄斑前膜的范围及和血管的关系以及老年黄斑变性中的玻璃膜疣和视网膜下新生血管。结论HRT-Ⅱ不仅可通过反射图显示不同黄斑疾病形态改变，其定量指标E值和W值在黄斑区发生病理改变时不同于正常眼。尤其是中央部E值，代表了黄斑区视网膜厚度和光强反射的共同变化，在黄斑水肿时改变最明显。（眼科，2006,15：245—249）

Objective To analyse the detection of The Heidelberg Retina Tomograph Ⅱ （HRT-Ⅱ） for macular diseases. Design Retrospective observational case series. Participants 110 patients （201 eyes）. Methods Fifty-two normal eyes, 74 eyes with macular edema, 23 eyes with macular hole, 31 eyes with macular premembrane and 21 eyes with choroidal neovascularization were examined with macular edema module（MEM） of HRT-Ⅱ. Main Outcome Measures Edema index （E value）, signal width value （W value） and features of reflectance pictures. Results In normal eyes, E value and W value of some areas in macula were partly associated with age （r=0.207-0.359）. E value and W value in macular diseases were significantly different from normal eyes （P=0.000）. HRT-Ⅱ could display macular edema cysts, configuration and size of macular holes, extension of macular premembrane and its relationship with retina and druen or subretinal neovascularization in age-related degeneration. Conclusion The reflectance pictures of HRT- Ⅱ have characteristic appearances in different macular diseases, and the measurements of E value and W value altered in pathologic stage of macular diseases. Especially E value of central zone can reflect changes of retinal thickness and light reflectance in macula, and it is obviously different in macular edema. （Ophthalmol CHN, 2006, 15：245-249）