频域光学相干层析成像对视网膜大动脉瘤的观察研究

Study of retinal arterial macroaneurysm by spectral domain optical coherence tomography

目的利用频域光学相干层析成像(OCT)观察视网膜大动脉瘤(RAM)的形态特征。方法回顾研究2014年7月~2017年12月于我院确诊的RAM患者的临床资料,分析OCT图像中RAM瘤体及其周围视网膜,以及黄斑的形态。结果 16例(16眼)患者入选。OCT显示,16眼RAM瘤体均表现为视网膜浅层轻度隆起的半圆形高反射病灶,其深部组织反射遮蔽。RAM瘤体周围视网膜病变包括:水肿16眼(100%),神经上皮下积液5眼(31.3%),渗出7眼(43.8%)。15眼(93.8%)还存在黄斑病变:黄斑水肿6眼(37.5%),黄斑神经上皮下积液6眼(37.5%),黄斑渗出10眼(62.5%),6眼存在2种或以上黄斑病变。结论 RAM瘤体在频域OCT中显示特征表现,有利于RAM的早期诊断,也为进一步治疗提供依据。

Objective To investigate the morphological characteristics of retinal arterial macroaneurysnl （RAM） in spectral domain optical coherence tomography （OCT）. Methods Medical records of the patients diagnosed as RAM from Jul. 2014 to Dec. 2017 were retrospectively reviewed. Clinical data were collected,and the OCT images were further analyzed. Results In total, 16 eyes from 16 patients were included. All the macroaneurysnls had a typical OCT appearance, a round hyperreflective wall with a hyporeflective lumen. RAM associated OCT findings included retinal edema （16 eyes, 100% ）, subretinal fluid（5 eyes,31.3% ） and intraretinal lipids （7 eyes, 43.8% ）. Fifteen （93.8%）eyes also had macular abnormalities, including retinal edema （6 eyes, 37.5% ） , subretinal fluid （6 eyes, 37.5% ） and intraretinal lipids （ 10 eyes, 62.5% ）. Conclusions Based on the typical appearance in OCT, RAM can be diagnosed early. It could be helpful in planning the treatment of RAM.