三维光学相干断层扫描在特发性黄斑前膜诊治中的应用

Clinical application of spectral domain optical coherence tomography in idiopathic epiretinal membrane

目的:应用三维光学相干断层扫描(3D-OCT)观察特发性黄斑前膜(idiopathic epiretinal membrane,IERM)的形态特征和临床应用。方法:应用3D-OCT观察IERM患者59例71眼,分析中心凹形态及感光细胞(IS/OS)情况。结果:IERM的3D-OCT图像表现为视网膜表面薄厚不一的高反光带,或紧贴于黄斑表面或与其部分相连。绝大多数黄斑中心凹变浅,厚度增加;术后黄斑区视网膜前膜消失。在59例71眼中合并板层裂孔者18眼、假性黄斑裂孔者17眼、弥漫水肿者15眼、中心凹正常者5眼、囊肿者16眼。结论:3D-OCT可以直接客观地显示IERM及手术前后黄斑部各种组织结构的改变,为IERM的临床诊断、手术效果及治疗评价提供了更加准确可靠的信息。

AIM：To explore the image characteristics and clinical application of the spectral domain optical coherence tomography（3D-OCT）in patients with idiopathic epiretinal membrane（IERM）.METHODS：A total of 59 cases 71 eyes of IERM were reviewed in this study.3D-OCT scanning was performed in all the patients and the parameters were analyzed.Morphological changes of macula zone from IERM were recorded.RESULTS：IERM was visible on 3D-OCT appeared as high reflective tissues,which were thin or thick,and contiguous to or anterior to the retinal surface.In most fovea,the depth decreased and the thickness increased.IERM disappeared after operation.Macular morphological changes were categorized into types of lamellarmacular hole（LMH）,macular pseudohole（MPH）,macular edema（ME）or foveal cyst（FC）and normal according to the findings of 3D-OCT.18 of 71 eyes were found with LMH,ME or FC,17 eyes with MPH,15 eyes with ME,16 eyes with FC,and 5 eyes were normal in studied patients.CONCLUSION：3D-OCT can display the macular epiretinal membrane and the pathological changes of macular tissues before and after operation.3D-OCT can provide accurate information on the clinical diagnosis and operative efficacy of IERM.