老年黄斑变性43例光学相干断层扫描分析

Optical coherence tomography on age-related macular degeneration

目的:研究老年黄斑变性的光学相干断层扫描(optical co-herence tomography,OCT)特征。方法:对经眼底荧光造影(fundus fluorescein angiography,FFA)确诊的老年黄斑变性患者43例45眼,其中湿性型28例30眼、干性型15例15眼,按年龄匹配的正常人30例43眼利用OCT分别进行检测。观察黄斑部神经纤维层(nerve fiber layer of macular,MNFL)、色素上皮/脉络膜毛细血管复合层(retinal pigment epithelium/choriocapil-laris,RPE/CC)及视网膜神经上皮层(retinal neurepith eliumlayer,RNE)的厚度变化。应用秩和检验比较其差异性。结果:MNFL厚度:湿性型老年黄斑变性组为76.5±51.7μm、干性型老年黄斑变性组为32.5±7.6μm、正常对照组为27.7±6.4μm,湿性型组与其他组比较差异有显著性(P﹤0.05)。RNE厚度:湿性型老年黄斑变性组为307.1±130.8μm、正常对照组为239.9±13.4μm、干性型老年黄斑变性组为223.4±22.6μm,湿性型组与其他组比较差异有显著性(P﹤0.05)。RPE/CC厚度:湿性型老年黄斑变性组为115.3±30.6μm、干性型老年黄斑变性组为81.7±20.4μm、正常对照组为76.4±11.5μm,湿性型组与其他组比较差异有显著性(P﹤0.05)。结论:黄斑部神经纤维层厚度、视网膜神经上皮层厚度及色素上皮/脉络膜毛细血管复合层厚度随着老年黄斑变性病程的发展,其厚度增加。OCT可以作为湿性型老年黄斑变性发生与发展的监测工具之一。

AIM： To observe the features of age-related macular degeneration （ARMD） on the optical coherence tomography （OCT）. METHODS： OCT was used to measure the healthy volunteers （30 people, 43 normal eyes） and patients with age-related macular degeneration （43 people, 45 eyes） that were divided into wet type group （28 person 30 eyes） and dry type group （15 person 15 eyes） were diagnosed by fundus fluorescein angiography （FFA）. The differences among the normal group and the age-related macular degeneration groups were compared. Statistical analysis was performed by SPSS version 12.0 under windows system to compare the nerve fiber thickness of macular （MNFL）, neurepithelium layer thickness （RNE） and retinal pigment epithelium / choriocapillaris （RPE/CC）. RESULTS： 1.The thickness of MNFL： 76.49± 51.72μ m in wet type group, 32.45 ± 7.59μm in dry type group, and 27.71 ± 6.40μm in normal group. The difference between the wet type group and other groups had statistically significant （P 〈 0.05）. 2.The thickness of RNE 307.12± 130.81μm inwet type group, 239.90± 13.39μm in normal group, and 223.38± 22.64μm in dry type group. The difference between the wet type group and other groups had statistically significant （P〈 0.05）. 3.The thickness of thickness of RPE/CC 115.33 ±30.62μm in wet type group, 81.67± 20.41μm in dry type group, and 76.38± 11.48μm in normal group was. The difference between the wet type group and other groups had statistically significant （P 〈 0.05）. CONCLUSION： MNFL, RNE and RPE/CC become thicker with the development of ARMD. OCT could be used to monitor the development of ARMD.