光学相干断层扫描检查电焊弧光损伤性视网膜病变的图像特征研究

Study of optical coherence tomography in clinical examination of welding arc damage retinopathy in patients with image features

目的探讨光学相干断层扫描检查电焊弧光损伤性视网膜病变的图像特征。方法收集2007年1月至2013年7月首都医科大学附属北京同仁医院眼科门诊的患者14例(28只眼)。为患者检查双眼视力,并进行眼底检查和光学相干断层扫描(OCT)检查。结果 14例(28只眼)患者全部同时发生电焊弧光损伤性视网膜病变。患者最佳矫正视力均显著下降。其中,患眼最佳矫正视力≤0.2者3例(6只眼),占21.43%;最佳矫正视力为0.3者8例(16只眼),占57.14%;最佳矫正视力为0.4者3例(6只眼),点21.43%。OCT检查,结果显示黄斑区的光感受器细胞内外节连接带(IS/OS)萎缩、脱失者14例(28只眼)占100%;光学相干断层扫描检查,结果显示视网膜色素上皮层(RPE)萎缩性改变者8例(16只眼)占57.14%。结论电焊弧光可以造成人眼视网膜的损害,常双眼同时发病。其损害主要造成视网膜黄斑区的光感受器细胞内外节连接带及视网膜色素上皮层的萎缩和/或脱失。而且,前者损害在此类患者中几乎皆有发生,后者损害可发生在部分患者当中。OCT的检查结果可以清晰地展示黄斑区的光感受器细胞内外节连接带层和视网膜色素上皮层的变化。因此,OCT检查是电焊弧光损伤性视网膜病变的有效检查方法。

Objective To discuss the image characteristics of optical coherence tomography for welding arc damage retinopathy objective.Methods From January 2007 to March 2014,14patients（28eyes）were collected from the Department of Ophthalmology of Beijing Tongren Hospital,Capital Medical University.To examine binocular vision and to examine fundus and optical coherence tomography（OCT）examination.Results 14cases（28eyes）were all simultaneous welding arc lesion of retinal injury.The best corrected visual acuity of the patients decreased significantly.Among them,the risk of eye best corrected visual acuity is less than or equal to 0.2（3cases（6eyes）,21.43%;best corrected visual acuity was 0.3in 8cases（16eyes）,accounting for 57.14%;the best corrected visual acuity of 0.4in 3cases（6eyes）,21.43%.Optical coherence tomography（OCT）.The results showed that the macular photoreceptor cell outer segments connected with（is/OS）atrophy,depigmentation in 14cases（28eyes）100%;optical coherence tomography.The results showed that retinal pigment epithelial layer（RPE）atrophic changes in 8cases（16eyes）accounted for 57.14%.ConclusionsWelding arc can make adult retinal damage,often eyes at the same time.The damage is mainly caused by macular retinal photoreceptor cell outer segments connected with and atrophy of the retinal pigment epithelial layer and/or depigmentation.Moreover,the former damage occurs almost in this kind of patients,the latter damage may occur in some patients.OCT examination results can clearly show the macular photoreceptor cell outer segments connected with layer and retinal pigment epithelial layer changes.Therefore,OCT examination is an effective inspection method of welding arc damage retinopathy.