光学相干断层成像对黄斑裂孔的诊断意义

The diagnostic significance of optical coherence tomography(OCT)for macular holes

目的 评价光学相干断层成像 (optical coherence tomography,OCT)对黄斑裂孔的诊断价值。方法 自 1999年 10月至 2 0 0 0年 2月我院 40例 45只眼临床诊断为黄斑裂孔的患者在双眼散瞳后行 OCT检查 ,并对图像进行测量和分析。结果 10例 (13只眼 ) OCT显示为板层裂孔 ,其黄斑中心凹处神经上皮厚度平均为 110μm,标准差为 41。全层黄斑裂孔 30例 (32只眼 ) ,5例为双眼黄斑全层或板层裂孔 ,平均裂孔直径为 6 2 1.2μm,标准差为194.1。全层裂孔者 OCT表现为黄斑中心凹处边界清晰的全层神经上皮缺失 ,裂孔周围视网膜增厚为 393.4±10 0 .7μm,并见无反射的暗腔。 5例行手术后裂孔封闭 ,黄斑中心凹正常反射曲线恢复。结论 OCT是一种非接触性、非侵入性、高分辨率的检测技术 ,临床上对于黄斑裂孔的定性及定量诊断具有非常重要的应用价值。

Objective To evaluate the diagnostic significance of OCT for macular holes.Methods 45 eyes of 40 patients which were diagnosed macular hole clinically had the OCT done through a dilated pupil bilaterally from October 1999 to February 2000.All images were measured and analyzed.Results The OCT technique showed laminar macular holes in 13 eyes of 10 patients with partial neural epithelium defect.The average thickness of the remained retina of the macular area was 110 μm,standard deviation(SD) is 41.32 eyes of 30 patients were full-thickness macular hole.5 cases were involved bilaterally.The average diameter of holes was 621.2μm,SD194.1.OCT showed neural epithelium disappeared completely in full-thickness macular hole,the average retina thickness arround the hole was 393.4±100.7 μm,and with nonreflective cavities.The mucular hole closed in 5 eyes after vitrectomy and gas tamponade.The normal fovea curve reappeared.Conclusion OCT is a noncontact,noninvasive and high resolution technique.It is very helpful in the diagnosis of macular holes.