频域光相干断层扫描诊断玻璃体黄斑牵拉综合征的临床观察

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

目的观察玻璃体黄斑牵拉综合征(vitreomacular traction syndrome,VMT)患眼的频域光相干断层扫描(spectral-domain optical coherence tomography,SD-OCT)影像特征,探讨SD-OCT在此类病变诊断、随访过程中的意义、价值。方法分析临床诊断明确的80例80眼VMT患眼的SD-OCT影像,总结VMT的SD-OCT特征性改变。结果按照玻璃体牵拉严重程度、对黄斑结构的影响将其分为3级:1级(轻度)32例,SD-OCT示黄斑受牵拉,但中心凹形态基本正常,玻璃体部分后脱离;2级(中度)25例,SD-OCT示黄斑受牵拉隆起,中心凹凹陷消失,变平坦,玻璃体部分后脱离;3级(重度)23例,SD-OCT示黄斑受牵拉隆起,"山峰"样突入玻璃体腔,玻璃体部分后脱离。结论 VMT具有特征性的SD-OCT表现,SD-OCT在VMT的诊断、随访、治疗时机的选择方面具有重要价值。

Objective To observe the characteristics of vitreomacular traction syndrome （VMT）on spectral-domain optical coherence tomography （SD-OCT）,and to investigate the significance of SD-OCT in the diagnosis and follow up of VMT.Methods We collected SD-OCT images of 80 eyes from 80 patients with clinical VMT,then summarized the features of VMT. Results Based on the vitreous traction severity and macular structure changes,we classified the SD-OCT into three degrees：stage 1 （mild degree,32 cases）normal central fovea,accompanied by posterior vitreous detachment（PVD）on SD-OCT;stage 2（moderate degree,25 cases）flattened central fovea by the drag of vitreous with posterior detachment;stage 3（severe degree,23 cases） macula tracted forward into vitreous cavity hill-like with vitreous adhesion at the macula. Conclusion The typical SD-OCT features of VMT make non-invasive SD-OCT the proper diagnostic and assessing measurement of VMT,and SD-OCT is of great help in diagnosis,follow up and choosing the appropriate treatment.