频域OCT检测年龄相关性黄斑变性患者黄斑厚度变化的研究

Changes in macular thickness measured by spectral-domain optical coherence tomography in patients with age-related macular degeneration

目的探讨频域OCT检测年龄相关性黄斑变性(AMD)患者黄斑厚度的变化及其临床意义。方法选择2014年2月至2015年2月门诊确诊的湿性AMD患者30例、干性AMD患者99例和正常对照116例,3组研究对象基线特征匹配。频域OCT检测根据ETDRS定义的以黄斑中心凹为圆心、6×6 mm范围内划分的9个黄斑分区视网膜厚度,对各组的检测结果进行比较。结果湿性AMD组、干性AMD组和对照组受检者黄斑区总平均厚度分别为(277.33±51.43)、(261.69±13.64)μm和(264.99±12.63)μm,3组之间总体比较差异有统计学意义(F=6.026,P=0.003),其中湿性AMD组明显高于对照组和干性AMD组,差异均有统计学意义(q=3.938、4.905,均P<0.05)。黄斑各分区中,湿性AMD组、干性AMD组和对照组受检者的黄斑中心凹平均厚度分别为(256.13±82.46)、(221.89±20.8)μm和(224.42±17.56)μm,3组之间总体比较差异有统计学意义(F=12.669,P<0.001),其中湿性AMD组明显高于对照组和干性AMD组,差异均有统计学意义(q=6.494、6.892,均P<0.05)。结论湿性AMD患者黄斑厚度增加,应用频域OCT检测黄斑厚度的变化可作为AMD患者诊断及治疗评价的监测指标。

Objective This study was to investigate the changes of macular thickness in patients with AMD measured by spectral-domain OCT. Methods Thirty patients with wet AMD and 99 patients with dry AMD were enrolled from February 2014 to February 2015. And 116 age and gender matched healthy volunteers were selected as controls. Macular thickness was measured by spectral-domain OCT for each of the 9 regions within a 6 × 6 mm area centered on the fovea,as defined by the ETDRS. Results Mean total macular thickness was 277. 33 ± 51. 43,261. 69 ± 13. 64,and 264. 99 ±12. 63 μm in the wet AMD,dry AMD and normal subjects,respectively,with a significant difference among the three groups（ F = 6. 026,P = 0. 003）. Mean total macular thickness was significantly higher in the wet AMD group than in control group and dry AMD group（ q = 3. 938,4. 905,both at P〈0. 05）. Among 9 regions of macular,mean macular fovea thickness was 256. 13 ± 82. 46,221. 89 ± 20. 8,and 224. 42 ± 17. 56 μm respectively,with a significant difference among the three groups（ F = 12. 669,P 0. 001）. Mean macular fovea thickness was significantly higher in the wet AMD group than in two other groups（ q = 6. 494,6. 892,both at P〈0. 05）. Conclusion Macular thickness increases in patients with wet AMD. The measurement of macular thickness by spectral-domain OCT may be a useful indicator in diagnosis and monitoring the development of AMD.