玻璃体黄斑牵引综合征的三维频域相干光断层扫描图像特征

Features of vitreomacular traction syndrome assessed with three-dimensional spectral-domain optical coherence tomography

目的探讨玻璃体黄斑牵引综合征的三维频域相干光断层扫描（OCT）图像特征。方法回顾性系列病例研究。收集18例经三维频域OCT检查确诊的玻璃体黄斑牵引综合征患者的临床资料进行回顾性分析，着重观察其三维频域OCT检测图像特征。根据频域OCT定量检测的玻璃体。与黄斑区视网膜附着粘连的范围，将玻璃体黄斑牵引综合征分为局灶型和宽大型两类。运用线性回归法分析所有患者的最小分辨角对数视力（logMAR视力）与黄斑中心凹部视网膜厚度的关系。结果玻璃体黄斑牵引综合征患者的频域OCT检测图像清晰，其病变特征明显。18例患者中，病变呈局灶型14例，宽大型4例；合并黄斑前膜8例，合并黄斑全层裂孔2例，合并黄斑板层裂孔2例。18只眼的logMAR视力为0．15—1．22，其黄斑中心凹视网膜厚度为275—899μm，经线性回归分析，显示所有患者的logMAR视力与黄斑中心凹的视网膜厚度呈中度线性正相关（r=0．616，P=0．007）。结论三维频域OCT检测可以直观地显示眼底病变三维结构，对玻璃体黄斑牵引综合征患者的诊断和随访具有重要作用。

Objective To describe features of vitreomacular traction syndrome （VMT） on threedimensional （3D） spectral-domain optical coherence tomography （SD OCT）. Methods Eighteen eyes of 18 patients with VMT were diagnosed by SD OCT. SD OCT images were obtained and retrospectively analyzed. These VMT cases were defined as focal type or broad type by the region of the vitreous attachment to the maeula. The relationship between the logMAR best corrected visual acuity （BCVA） and the retinal thickness of maeular fovea was evaluated by linear regression analysis. Results SD OCT provided detailed 3 D images of VMT and revealed information about the extent of vitreomacular traction. Focal VMT was seen in 14 eyes. Broad VMT was seen in four eyes. Eight cases had concurrent epiretinal membrane in the areas surrounding the fovea. Two cases had concurrent full thickness macular hole and two cases had concurrent lamellar macular hole. LogMAR BCVA correlated with the retinal thickness of macular fovea （ r = 0. 616, P = 0. 007, linear regression analysis）. Conclusions SD OCT allows good visualization of the architectural morphology of the vitreous and retina in vitreomacular traction syndrome. It is useful and irreplaceable for the diagnosis and follow-up of VMT.