SD-OCT在玻璃体视盘牵拉综合征诊断中的临床观察

CLINICAL OBSERVATION OF SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY IN DIAGNOSIS OF VITREOPAPILLARY TRACTION SYNDROME

目的观察、探讨玻璃体视盘牵拉综合征患者频域光相干断层成像(spectral-domain optical coherence tomography,SD-OCT)的特点,以提高该类疾病的临床诊断率以及SD-OCT在此类疾病随访观察中的应用价值。方法分析SD-OCT明确诊断的118例120眼的影像图片,总结该类病变的影像学特征。结果依据玻璃体对视盘的牵拉程度不同,将SD-OCT影像分为3级:3级(重度),玻璃体后脱离,玻璃体腔内较高的反射信号条带于盘周与视盘相连,视盘受牵拉隆起变形、突向玻璃体腔;2级(中度),玻璃体后脱离,玻璃体腔内中等反射信号条带与视盘相连,视盘受牵拉稍隆起;1级(轻度),玻璃体后脱离,于盘周与视盘相连,但视盘形态正常。结论玻璃体视盘牵拉综合征具有特征性的SD-OCT影像,可以实现对该类病变的明确诊断,并可评价牵拉的严重程度,同时SD-OCT检查具有无创性,因此SD-OCT在玻璃体视盘牵拉综合征的诊断及随访观察中具有重要价值。

Objective To observe and analyze the characteristics of vitreopapillary traction syndrome （VPT） on spectral-domain optical coherence tomography （SD-OCT）, and to evaluate its significance in diagnosis and follow up of VPT. Methods We collected SD-OCT images of 120 eyes from 118 subjects with VPT,and summarized the features successively. Results According to the severity of the traction, we classified the SD-OCT images into three stages： stage 3 （severe ones） with deformed papilla tracted forward into vitreous by high refractive band, accompanied by partial posterior vitreous detachment （PVD） ; stage 2 （ moderate ones） papilla tracted forward into vitreous with medium refractive band in vitreous cavity, accompanied by partial PVD; stage 1 （mild ones） normal-shape papilla with low- to-medium refractive band connected to the papilla, accompanied by partial PVD. Conclusion The specific features of VPT on SD-OCT entitle SD-OCT to precisely diagnosing VPT and evaluating severity of the traction. As a non-invasive measurement, SD-OCT is of great value in the diagnosis and follow-up of VPT.