频域OCT在光动力疗法治疗病理性近视脉络膜新生血管中的应用

Application of spectral-domain OCT in photodynamic therapy for choroidal neovascularization in pathologic myopia

目的评价频域光学相干断层扫描(optical coherence tomography,OCT)检查在光动力疗法(photodynamic therapy,PDT)治疗病理性近视所致的黄斑区脉络膜新生血管(choriodal neovascularization,CNV)中的临床应用价值。方法对比分析21例26眼病理性近视患者PDT治疗前后频域OCT图像中黄斑中心凹层间厚度及外层高反射厚度,观察不同时期OCT的形态变化。结果 26眼CNV生长方式均属于Ⅱ型。PDT治疗后6个月18眼视网膜层间厚度恢复,视网膜下液吸收,CNV反光团逐渐缩小或纤维化,中心凹形态恢复。黄斑中心凹层间厚度治疗后1周(339.96±74.40)μm增加,治疗后1个月(267.78±33.39)μm开始下降,且差异均有统计学意义(均为P<0.05)。外层高反射厚度与术前(247.33±49.31)μm相比,从治疗后1个月(226.73±83.15)μm开始明显减少,但仅治疗后6个月(165.15±22.90)μm时差异有统计学意义(P=0.042)。结论频域OCT对病理性近视CNV行PDT治疗前后视网膜形态结构的连续观察具有重要意义,为临床治疗提供一种安全、无损伤的检测方法。

Objective To evaluate the application of spectral-domain optical coherence tomography (OCT) in photodynamic therapy (PDT) for macular choroidal neovascularization (CNV) due to pathological myopia.Methods The spectral-domain OCT images of 21 patients (26 eyes) with pathologic myopia before and after PDT were compared and analyzed.The macular foveal thickness and outer high reflectivity band thickness were evaluated,and the morphological changes at different periods was observed by OCT.Results Among the observed 26 eyes,the mode of CNV living belonged to type II.At 6 months after PDT,the macular foveal thickness was decreased,the sub-retinal fluid was resolved,and the size of CNV was smaller,the retinal neuroepithelial edema was alleviated. The center of the bilaminar foveal thickness of the macula at postoperative 1 week increased,which was (339.96±74.40)μm,that at postoperative 1 month after treatment began to decline,which was (267.78±33.39)μm,and the difference was statistically significant(both P<0.05).Outer high reflectivity band thickness started to decrease at postoperative 1 month decreased,which was (226.73±83.15)μm,but compared with pre-operation (247.33±49.31)μm,there was only statistical difference at postoperative 6 months,which was (165.15±22.90)μm(P=0.042).Conclusion The spectral-domain OCT for the continuous observation of the retinal morphology in macular CNV due to pathological myopia before and after PDT treatment is provided with the great significance.