黄斑前膜患者激光视网膜成像特点分析

Diagnostic performance of laser retinal imaging in the epiretinal membrane

目的 探讨基于共聚焦激光扫描检眼镜（cSLO）的视网膜成像技术在黄斑前膜（ERM）患者中的诊断评估作用.方法 回顾性研究.对象为2015年6月至10月就诊于首都医科大学附属北京同仁医院眼底病门诊,确诊为ERM的患者共26例（32只眼）.应用频域光学相干断层扫描（SD-OCT）进一步明确诊断.应用基于cSLO的海德堡炫彩视网膜成像技术和传统彩色眼底照相对患者进行视网膜成像的比较,根据SD-OCT扫描结果对每个ERM视网膜图像进行分析并评分.结果 基于cSLO的海德堡炫彩视网膜成像技术对ERM的评分中,蓝绿加强炫彩成像（3.44±0.80）、标准炫彩成像（2.84±0.85）、绿光反射（2.16±0.77）、蓝光反射（2.09±0.78）均明显高于传统彩色眼底照相（1.28±0.81）（P值均＜0.001）.而cSLO视网膜成像中的红外反射评分（1.13±0.71）,与传统彩色眼底照相无明显差别（P=0.282）.结论 基于cSLO的海德堡炫彩技术对于ERM患者所获得的视网膜图像的成像质量明显好于传统彩色眼底照相技术,结合SD-OCT断层扫描图像可以帮助医师更好地诊断并监测ERM.

Objective To determine the diagnostic performance of confocal scanning laser ophthalmoscope （cSLO）-based retinal imaging in the epiretinal membrane （ERM） patients.Methods Prospective case series study.Twenty-six patients （32 eyes） with ERM determined by spectral domain optical coherence tomography （SD-OCT） were recruited from June 2015 to October 2015 in the Beijing Tongren Eye Center.All subjects underwent retinal imaging using the cSLO-based Heidelberg MultiColor （Spectralis HRA-2;Heidelberg Engineering） technology and the traditional color fundus camera.A special grading score was used to analyze every retinal image according to the SD-OCT results.Results In the ERM patients,the largest average grading score in the cSLO-based retinal imaging was 3.44±0.80 with the blue and green enhanced MultiColor image,followed by the standard MultiColor image （2.84±0.85）,green laser image （2.16±0.77） and blue laser image （2.09-J-0.78）,and they all had statistical differences compared with the grading scores of retinal imaging using the traditional color fundus camera （all P〈0.001）.No significant difference was found in grading scores between using the infra-red laser imaging （1.13±0.71） and the traditional color fundus camera （P=-0.282）.Conclusion In the detection of ERM,the imaging quality of cSLO-based Heidelberg MultiColor technology is better than the traditional color fundus camera technology.Combined with SD-OCT sectional analysis,it can help diagnose and monitor ERM.