糖尿病视网膜病变患者黄斑病变的光学相干断层扫描

The pattern characteristics of optical coherence tomography in diabetic maculopathy

目的 观察糖尿病视网膜病变患者黄斑病变的光学相干断层扫描 (optical coherence tomo-graphy,OCT)图像特征。 方法 对 6 0例糖尿病黄斑病变患者以及 30例正常对照者进行 OCT检查。其中5 4例糖尿病黄斑病变患者同时行荧光素眼底血管造影 (fundus fluorescein angiography,FFA)检查 ,对两种检查方法的结果进行比较。 结果 OCT检查糖尿病黄斑病变患者中心凹平均厚度为 (314.5 4±15 4.13) μm。视网膜水肿者占 5 7.1% ,视网膜水肿合并黄斑囊样水肿 (cystoid macular edema,CME)者占38.5 % ,合并神经上皮脱离者占 9.2 % ,合并 CME及神经上皮脱离者占 16 .9%。OCT检查黄斑正常厚度及轻度水肿者 ,FFA主要呈限局性渗漏 ;中重度水肿者 ,FFA呈弥漫性渗漏。 CME检出率 FFA检查者为2 8.6 % ,OCT检查者为 5 8.9% ,二者比较差异有显著性意义 (t=3.39,P<0 .0 5 )。 结论 糖尿病黄斑病变者的 OCT图像有视网膜水肿、CME及神经上皮脱离 3种形态特征。 OCT在检测发现 CME等方面优于FFA。

Objective To verify the pattern characteristics of optical coherance tomography (OCT) images in diabetic maculopathy (DM). Methods OCT were performed in sixty cases of DM and 30 cases of normal control group,and in 54 cases of DM,fundus fluorescein angiography (FFA) was performed simutaneously.The results from 2 kinds of examinations were compared each other. Results The average retinal thickness at the central fovea was (314.54±154.13) μm in DM group.The macular edema in the cases of DM accounted to 57.1% on OCT examination The rate of retinal swelling associated with cystoid macular edema (CME) was 38.5%,with retinal detachment (RD) 9.2%,and with both CME and RD was 16.9% Those with mormal macular thickness and mild macular edema primarily showed focal leakage in FFA exam,while those with moderate and severe macular edema showed diffuse leakage in FFA exam.The rate of CME was 28.6% presented in FFA and 58.9% in OCT examination (t=3.39,P<0.05). Conclusion OCT images of DM reveal 3 kinds of morphological features:retinal welling,CME,and sensory retinals detachment.OCT is superior to FFA in detecting CME.