B超检查在黄斑区微小病变诊断的应用

Application orB-scan in diagnosis ofmacular micropathology

目的 探讨B型超声检查对于白内障术前黄斑区微小病变的诊断价值,从形态结构方面协助对白内障术后视功能恢复的评价.方法 选取45例白内障术后经眼底摄片、OCT确诊的不同类型黄斑病变的患眼,将它们术前的B超不同程度的形态改变特征与OCT观察的黄斑中心平均视网膜厚度、黄斑中心视网膜体积的改变相比较.结果 B超0级组黄斑中心厚度和黄斑中心体积分别（278.29±75.66）μm和（0.26±0.13）mm3,B超1级组黄斑中心厚度和黄斑中心体积分别为（395.00±70.71）μm和（0.49±0.30）mm3,B超2级组黄斑中心厚度和黄斑中心体积分别为（336.58±69.66）μm和（0.27±0.06）mm3,B超3级组黄斑中心厚度和黄斑中心体积分别为（543.90±90.85）μm和（0.43±0.09）mm3.B超分级与黄斑中心厚度呈线性相关（F=44.849 P〈0.01）.B超分级与黄斑中心体积呈线性相关（F=8.260 P〈0.01）.结论 随着黄斑中心视网膜厚度和体积的增加,B超的阳性率也增加.B超对黄斑区局部视网膜增厚识别敏感度较高,但对视网膜后极部弥漫性视网膜增厚识别敏感度较低.提示在屈光间质混浊眼,特别是白内障术前B超检查对于黄斑区微小病变的早期诊断及术后视力预测有一定的参考价值.

Objective To investigate the value of B-scan in diagnosis ofmacular micropathology before cataract phacocmulsification and evaluate the visual function after cataract phacocmulsification in structure. Methods A total of 45 cases of macular micropathology diagnosed after cataract phacocmulsification were compared with finding of B-scan, fundus photographs and OCT. Results The central macular thickness and volume in classification 0 by B-scan was 278.29± 75.66um and 0.26± 0.13mm3, in classification 1 was 395.00± 70.71um and 0.49± 0.30mm3, in classification 2 was 336.58± 69.66um and 0.27± 0.06mm3, and in classification 3 was 543.90± 90.85um and 0.43± 0.09mm3. It was linear correlated between the classification and the central macular thickness （F =44.849,P 〈0.01）, and the classification and the central macular volume （F=8.267, P 〈0.01）. Conclusions There is positive correlation between thicknesses ofmacular to the classification by B-scan. The sensitivity of B-scan in the local thickening in macular is higher than the dispersion thickening. In patient with refractive media opacity, it is valuable to use B-scan to diagnose macular micropathology before cataract phacoemulsification and predict the visual function after cataract phacoemulsification.