应用光学相干断层扫描观察玻璃体牵拉视网膜的特征

Characteristics of vitreoretinal traction with optical coherence tomography

用光学相干断层扫描 (OCT)描述玻璃体牵拉视网膜不同时期的特征。方法 :对 12 1例 ,14 7眼 ,诊断为视网膜前膜或有玻璃体视网膜牵拉者行OCT检查。每眼均行四个方向放射状线性扫描。结果 :OCT证实 112例 (83 % ) ,13 8眼 (94% )符合玻璃体牵拉视网膜的各种特征。黄斑部视网膜厚度增至 3 44 8± 13 5 1um ,范围为 13 8～ 865um。 49眼有玻璃体后脱离、 5 5眼有部分玻璃体后脱离的高反光带。 5 6眼有程度不同的视网膜囊样水肿 ,OCT表现为视网膜增厚伴有低反射腔隙。 2 4眼为Ⅱ期以上黄斑孔。 2 6例双眼受累。平均视力为 0 45 8± 0 3 2 ,范围为 0 0 1～ 1 2。结论 :OCT可帮助发现玻璃体牵拉视网膜发展至黄斑裂孔的全过程 。

Objective:To present the characteristics of vitreo retinal traction under optical coherence tomography. Methods:147 eyes of 121 patients with epiretinal membrane or vitreo retinal traction diagnosed clinically were examined under optical coherence tomography (OCT).The linear scans in four radial directions were run on each eye at a length of 4mm. Results:138 eyes (94%) of 112 patients (83%) were with the different characteristics of vitreo retinal traction at different stages under OCT.The retina at the fovea thickened to 344.8±135.1μm (138～865μm).49 eyes were with the high reflection band from the inner surface of retina implied the complete vitreous separation,55 eyes with the high reflective band of the partial vitreous separation.56 eyes complicated with retina cystoid edema,in which OCT showed the thicken retina with some low reflective cavity.24 eyes were with macular hole at stage Ⅱ or more.26 cases were bilateral lesion.The mean visual acuity was 0.458±0.32 (0.01 to 1.2). Conclusions:OCT is helpful for the detection of the developmental process from vitreous traction to macular hole and for the earlier treatment of the disease.