光学相干断层扫描对视网膜静脉阻塞黄斑病变的诊断价值

Diagnostic Value of Optical coherence Tomography for Macular Degeneration of Retinal Vein Occlusion

目的:探讨分析光学相关断层扫描(OCT)技术对视网膜静脉阻塞黄斑病变的诊断价值,为临床诊断提供依据。方法:选择在医院诊治的视网膜静脉阻塞患者182例(230眼),所有患者均行激光诱导脉络膜视网膜静脉吻合术,术前均经OCT和前置镜进行黄斑部检查,比较两种方法对视网膜静脉阻塞患者黄斑病变的检出率。结果:OCT检查114例(138眼)有黄斑病变,检出率为60.0%(138/230);前置镜检查85例(109眼)有黄斑病变,检出率为47.4%(109/230),经Mc Nemar检验可知,OCT检查对视网膜静脉阻塞患者黄斑病变的检出率高于前置镜检查(χ~2=10.345,P<0.01)。以FFA检查为诊断"金标准",OCT检查诊断视网膜静脉阻塞患者黄斑病变的灵敏度和特异度分别为95.7%(132/138)、96.7%(89/92);前置镜检查诊断视网膜静脉阻塞患者黄斑病变的灵敏度和特异度分别为67.0%(73/109)、48.8%(59/121),OCT检查诊断视网膜静脉阻塞患者黄斑病变的灵敏度和特异度均高于前置镜检查。结论:OCT对视网膜静脉阻塞患者黄斑病变的检出率较高,有较高的灵敏度和特异度,可以准确地发现不同种类黄斑部的结构改变,为临床医生提供有效的诊断依据。

Objective： To analyze the optical correlation tomography（ OCT） diagnostic value for retinal vein occlusion macular degeneration,providing the basis for clinical diagnosis. Methods： 182 patients（ 230 eyes） with retinal vein occlusion were selected. All patients underwent laser induced choroidal retinal vein anastomosis. All patients underwent macular examination before and after OCT. The detection rates of macular lesions in two patients with retinal vein occlusion were compared. Results： OCT checked 114 cases（ 138 eyes）with macular degeneration,detection rate was 60.0%（ 138/230）. Front mirror checked 85 cases（ 109 eyes）with macular degeneration,detection rate was 47.4%（ 109/230）. Through the Mc Nemar test,detection rate of OCT examination for retinal vein occlusion patients with macular lesion was higher than the front mirror examination（ χ^2= 10.345,P〈0.01）.Taking FFA examination as the ＂ gold standard＂,the sensitivity and speciality of OCT examination diagnosing retinal vein occlusion patients with macular degeneration respectively was95.7%（ 132/138）,96. 7%（ 89/92）; the sensitivity and speciality of front mirror examination respectively was 67.0%（ 73/109）,48.8%（ 59/121）,the sensitivity and speciality of former were higher than the latter.Conclusion： OCT to macular lesion detection rate is higher in patients with retinal vein occlusion,having higher sensitivity and speciality. It can accurately found different types of macular structural changes and provide the effective diagnosis basis for the clinical doctors.