原发性视网膜色素变性的频域光学相干断层成像特征

Fourier-domain optical coherence tomography characteristics in primary retinitis pigmentosa

目的观察原发性视网膜色素变性即色素性视网膜炎(retinitis pigmentosa,RP)的频域光学相干断层扫描检查(fourier-domain optical coherence tomography,FD-OCT)的图像特征。方法回顾性分析经临床确诊的30例60眼RP患者及30例60眼正常人FD-OCT检查资料,比较分析视网膜厚度及图像特征。结果正常组黄斑中心视网膜厚度为(174.6±14.9)μm;RP组黄斑中心视网膜厚度为(146.0±21.5)μm;RP组黄斑中心视网膜厚度较正常组降低,两组比较差异有统计学意义(t=3.487,P=0.001)。RP患者骨细胞样视网膜色素沉着区FD-OCT图像可见病变区色素上皮层光带断裂,与其相对应的神经上皮层可见增殖移行的色素上皮,黄斑区FD-OCT图像见光感受器内外节连接层反射部分或全部消失伴视网膜色素上皮层萎缩变薄。RP组中伴神经上皮层弥漫水肿5眼;黄斑囊样水肿3眼;黄斑前膜17眼。结论 FD-OCT可显示RP的组织病理改变,其影像学特征对临床诊断及病程估计有重要意义。

Objective To observe the characteristic of fourier-domain optical coherence tomography（FD-OCT） images of primary retinitis pigmentosa（RP）.Methods FD-OCT images of 30 patients（60 eyes） with RP and 30 cases（60 eyes） of normal subjects were retrospectively analyzed.Retinal thickness and morphological characteristic were compared among them.Results Retinal thickness at macular fovea in normal and RP group were（174.6±14.9）μm and（146.0±21.5）μm.Retinal thickness at macular fovea in RP group was significantly decreased,the differences was significant（t=3.487,P=0.001）.FD-OCT images in patients with RP showed a broken reflected light appeared in pigment layer of retinal areas,and its corresponding retina could see the migration of pigment epithelium with strong reflected light.FD-OCT images in macular area showed the reflection of inner and outer segments photoreceptor junction layer disappeared with retinal pigment epithelium atrophy.In RP group,the retinal neurosensory edema appeared in 5 eyes,cystoid macular edema in 3 eyes,and epiretinal membrane in 17 eyes.Conclusion FD-OCT images can show the pathological change of tissues in primary RP,which is significant for evaluation and clinical diagnosis of RP.