视网膜色素变性黄斑区外层视网膜管状结构的OCT特征及临床意义

Optical coherence tomography characteristics and clinical significance of the outer retinal tubular structure in retinitis pigmentosa

目的观察视网膜色素变性(RP)患者黄斑区外层视网膜管状结构(ORT)的相干光层析成像术(OCT)形态特征及其分布特点。方法回顾性分析127例(254只眼)RP患者黄斑部OCT图像,对RP患者中ORT的发病率、形态特点、数量、分布位置特点进行分析总结。结果通过观察127例RP患者OCT结构扫描,发现有13例双眼黄斑区存在ORT改变,ORT在RP中发病率约为10.23%。其中结晶样RP中发病率约40%,原发性RP中发病率约4.67%。通过分析OCT结构扫描可观察到ORT表现为圆形或近椭圆形环状低反射暗腔,其内壁呈多点状高反射或低反射,主要位于视网膜外核层。ORT的宽度为21~892μm,高度为29~218μm,每张OCT图像可见1~8个ORT。结论ORT表现位于视网膜外核层的圆形或近椭圆形环状低反射暗腔,其内壁呈多点状高反射或低反射。RP患者黄斑区可见ORT改变,其中结晶样RP中发病率较高。

Objective To assess the optical coherence tomography(OCT) morphological and distribution characteristics of the outer retinal tubular(ORT) structure in the macular area of patients with retinitis pigmentosa(RP).Methods The macular OCT images of 127 patients(254 eyes) with RP were retrospectively analyzed. The incidence, morphological characteristics, quantity and location of ORT were analyzed and summarized. Results ORT changes were present in the macular area of both eyes in 13 patients. The incidence of ORT among RP patients was about 10.23%. Specifically, the incidence among crystalline RP is about 40%, while the incidence among primary RP is about 4.67%. The ORT was observed as a circular or elliptical annular low-reflection dark cavity with multi-point high reflection or low reflection on the inner wall, and mainly located in the outer nuclear layer of the retina. ORT has a width of 21~892 μm and a height of 29~218 μm. One to 8 ORTs could be seen on each OCT image. Conclusions ORT is a circular or elliptical annular low-reflection dark cavity located in the outer nuclear layer of the retina, with multi-point high reflection or low reflection on the inner wall. ORT changes were seen in the macular area of RP patients, with a higher incidence among crystalline RP.