频域光学相干断层扫描图像增强技术检测轻中度近视青少年散瞳前后黄斑中心凹下脉络膜厚度的变化

Changes in subfoveal choroidal thickness before and after dilation in adolescents with mild and moderate myopia observed with enhanced depth imaging spectral-domain optical coherence tomography

目的 应用频域光学相干断层扫描图像增强技术（EDI-OCT）检测轻中度近视青少年散瞳前与散瞳后,散瞳当日与次日的黄斑中心凹下脉络膜厚度的变化.方法 前瞻性临床研究.对58例（116眼）患者给予复方托吡卡胺滴眼液散瞳.散瞳前、散瞳后及散瞳次日行双眼EDI-OCT检查,以长度为8.8 mm的扫描线段对被检眼黄斑中心凹水平和垂直方位进行扫描,测量黄斑中心凹下脉络膜厚度值及黄斑中心凹处视网膜厚度值.数据采用独立样本t检验和配刘样本t检验进行分析.结果 本组患者散瞳后脉络膜厚度比散瞳前变小,差异有统计学意义（右眼：t=4.305,P＜0.01；左眼：t=5.007,P＜0.01）.散瞳后络膜厚度比次日脉络膜厚度小,差异有统计学意义（右眼：t=-3.237,P＜0.01；左眼：t=-3.011,P＜0.01）.散瞳前络膜厚度与次日脉络膜厚度比较,差异无统计学意义（右眼：t=-0.300,P＞0.05；左眼：t=-0.333;P＞0.05）.散瞳前、散瞳后及散瞳次日双眼间视网膜各项数值比较,差异无统计学意义.结论 EDI-OCT检测到轻中度近视青少年患者在使用复方托吡卡胺滴眼液散瞳后的脉络膜变薄.该技术可以无创地、直观地观察到药物对活体组织作用引导的细微变化.

Objective To study the choroidal thickness of the macula subfovea using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) before dilation,after dilation,the following day after dilation.Methods Prospective clinical study.Fifty-eight patients (116 eyes) were dilated with tropicamide eye drops.All patients were examined with EDI-OCT before dilation,after dilation and the following day after dilation.Then,the eyes were scanned with a 8.8 mm scan line in the horizontal and vertical directions.Finally,the subfoveal choroidal thickness and the retinal thickness of the fovea were measured.Data were analyzed using independent t test and paired t test.Results Choroidal thickness after dilation was thinner than before dilation.The difference was statistically significant (right eye:t=4.305,P＜0.01; left eye:t=5.007,P＜0.01).Choroidal thickness after dilation was thinner than that measured the next day after dilation,and the difference was statistically significant (right eye:t=-3.237,P＜0.01; left eye:t=-3.011,P＜0.01).However,the difference between choroidal thickness before dilation and the next day after dilation was not statistically significant (right eye:t=-0.300,P＞0.05; left eye:t=-0.333,P＞0.05).There was no significant difference between binocular retinal values measured before dilation,after dilation,or the following day after dilation.Conclusion The choroid becomes thinner after using tropicamide eye drops when measured by EDI-OCT,which is noninvasive and intuitive to observe the subtle changes in living tissue after drug use.