眼底荧光血管造影联合光学相干断层照相在诊断治疗渗出性视网膜脱离中的临床分析

Fundus Fluorescence Angiography in Combination with Optical Coerence Tomography in the Diagnosis of Clinical Analysis for the Treatment of Exudative Retinal Detachment

目的探讨眼底荧光血管造影联合光学相干断层照相在诊断治疗渗出性视网膜脱离中的作用。方法选取我科收治的6例视网膜脱离经眼底镜,三面镜检查未发现裂孔者行眼底荧光血管造影联合光学相干断层照相。结果渗出性视网膜脱离眼底荧光血管造影表现5例为后极部为主,可伴有中周边多灶性针尖样和斑驳样荧光,后期可见渗漏增强,1例患者表现为多灶性强荧光渗漏,OCT检查表现为视网膜神经上皮层浆液性脱离、色素上皮层结构破坏,治疗针对病因及抗炎对症治疗后恢复。结论由于渗出性视网膜脱离一般伴有全身病(如妊娠高血压综合征),眼部的严重葡萄膜炎包括特发性葡萄膜炎,交感性眼炎,严重的视网膜由于渗出性视网色素上皮病变(如特重型中心性浆液性视网膜脉络膜病变),脉络膜渗漏症等,而上述病变通过眼底荧光血管造影可以诊断,OCT可以动态观察本病在治疗过程中的变化,因此眼底荧光血管造影联合光学相干断层照相的影像检查对于渗出性视网膜脱离的诊断及观察治疗效果起到了积极作用。

Objective Explore the fundus fluorescence angiography combined optical coherence tomography in the diagnosis and treatment of exudative retinal detachment. Method Selection of 6 cases of retinal detachment admitted in our department by ophthalmoscope, three sides mirror examination was found in the line of fundus fluorescence angiography combined optical coherence tomography. Result Exudative retinal detachment after fundus fluorescence angiography performed in 5 cases of pole of the primarily, may be accompanied by the surrounding multifocal needlepoint sample and mottled fluorescence, the late visible leakage increase, 1 patient show multiple focal strong fluorescence leakage, OCT examination showed serous detachment of retinal nerve epithelium, destruction of pigment epithelial layer structure, treatment for the cause of disease and anti inflammatory treatment after the recovery. Conclusion Because the exudation of retinal detachment is generally accompanied by systemic disease（Such as pregnancy induced hypertension syndrome）, serious ocular uveitis including idiopathic uveitis, sympathetic ophthalmia, severe retinal pigment epithelial lesions due to the exudation（Severe central serous retinopathy, central serous）, choroidal leakage, et al. The above pathological changes can be diagnosed by fundus fluorescein angiography, OCT can dynamically observe the changes of the disease during the treatment. Therefore, the diagnosis and observation of the diagnosis and treatment of the retinal detachment by fundus fluorescein angiography and optical coherence tomography can play a positive role in the diagnosis and treatment.