埋藏性视盘玻璃膜疣的影像学诊断分析

Diagnostic image analysis of buried optic disc drusen

目的探讨眼科B超、眼底血管造影（FFA）及光学相干断层扫描（OCT）对埋藏性视盘玻璃膜疣（ODD）的诊断价值。方法对2009年12月至2013年9月在荆州市中心医院眼科回顾性分析14例（23只眼）埋藏性ODD患者的临床资料，所有患者均行眼科常规检查及双眼B超、OCT检查，其中10例患者行FFA检查，5例行头部及眼眶CT检查。结果B超检查结果可见视盘前方强回声光团。OCT检查发现患眼视盘视网膜神经纤维层（RNFL）高度隆起，其下方可见团块状高反射信号。FFA可见出血部位呈遮蔽荧光，无出血时仅表现为视盘荧光着染，晚期未见荧光渗漏。CT检查颅内及眶后均未见明显异常。结论B超＋OCT是诊断埋藏性视盘玻璃膜疣的可靠方法，FFA对此病的鉴别诊断有帮助，联合应用可以提高检出率，避免误诊。

Objective To observe and study the characteristics of buried optic disc drusen （ODD） with B-ultrasonic, optic coherence tomography （OCT） scanning and fundus fluorescein angiog- raphy （FFA）. Methods Fourteen patients （23 eyes） with buried ODD were included in this study. Routine examination, B-ultrasonic and OCT were performed in all patients. Ten patients received FFA, 5 patients were examined by CT scan. Results B-ultrasonic showed high echo mass ahead of the optic disc. OCT revealed the prominent RNFL of the optic disc and a hyperreflexia signal under- neath. The FFA showed that the optic discs were early stained and no fluorescence leakage on late period. When bleeding, FFA manifested blocked fluorescence. CT scan had no abnormal appearance. Conclusions B-ultrasonic plus OCT can serve as an accurate and reliable diagnostic method for bur- ied ODD, and FFA is an assistant in the differential diagnosis. The combination of the methods can elevate the detection rate and avoid misdiagnosis.