健康成年人泪点相干光层析成像术检查的初步研究

A preliminary study on optical coherence tomography of the lacrimal punctum in normal adults

目的观察健康成年人泪点相干光层析成像术(OCT)检查的成像特点.方法横断面研究.收集2018年9至11月解放军总医院第三医学中心泪器病中心自愿接受检查的泪点结构正常的健康成年人59名(90只眼),其中男性21名(34只眼),女性38名(56只眼),年龄18~65岁.以受检者下泪点为研究部位,进行裂隙灯显微镜检查、OCT检查,测量裂隙灯显微镜下泪点最大横径、OCT泪点外径及深度为100μm及200μm处泪点直径.采用独立样本t检验及单因素方差分析比较裂隙灯显微镜与OCT检查结果的差异以及OCT检查不同扫描位点泪点直径的差异.结果健康成年人裂隙灯显微镜下泪点最大横径为(545.6±149.3)μm;OCT检查泪点外径为(548.4±130.5)μm,深度为100μm处泪点直径为(262.8±120.8)μm,200μm处泪点直径为(179.2±110.0)μm.裂隙灯显微镜下泪点最大横径与OCT检查泪点外径比较差异无统计学意义(t=0.133,P=0.894).OCT不同扫描位点的泪点直径比较差异有统计学意义(F=213.237,P<0.01),两两比较显示深度100、200μm处的泪点直径与泪点外径差异均有统计学意义(t=15.229、20.517,均P<0.01),深度200μm处泪点直径与深度100μm处泪点直径差异有统计学意义(t=4.855,P<0.01).结论 OCT检查健康成年人泪点各部位宽窄程度不同,OCT下深度200μm处直径最窄.

Objective To study the imaging characteristics and accumulate data of optical coherence tomography (OCT) of the lacrimal punctum in normal adults. Methods From September to November 2018, 59 healthy adults (90 eyes) with normal lacrimal punctum structure were enrolled in this cross?sectional study conducted at the Lacrimal Center of Ophthalmology, Third Medical Center of PLA General Hospital, including 21 males (34 eyes) and 38 females (56 eyes), aged 18-65 years. All the subjects were examined by slit lamp microscopy to measure the maximum transverse diameter. OCT was performed to observe the inferior lacrimal punctum, including the external punctal diameter, the punctal diameter at 100 μm and 200 μm depth. The difference in the diameter of different parts of the punctum was analyzed. Independent sample t test and single factor analysis of variance were used for statistical analysis. Results In normal adults, the maximum transverse diameter under a slit lamp was (545.6±149.3)μm, the external punctal diameter on OCT images was (548.4±130.5)μm, and the punctal width at 100 μm and 200 μm depth on OCT images was (262.8±120.8)μm and (179.2±110.0)μm, respectively. There was no significant difference between the maximum transverse diameter of the punctum under a slit lamp microscope and the OCT outer diameter of the punctum (t=0.133, P=0.894). There were significant differences between the diameter of the lacrimal punctum in the different scanning sites of the OCT (F=213.237, P<0.01). There was significant difference between the punctal width at 100 μm and the external punctal diameter on OCT images (t=15.229, P<0.01). There was significant difference between the punctal width at 200 μm and the external punctal diameter on OCT images (t=20.517, P<0.01). There was significant difference between the punctal width at 100 μm and 200 μm depth on OCT images (t=4.855, P<0.01). Conclusion The width of different parts of the lacrimal punctum in healthy adults is different on OCT images, and the punctal width at 200 μm depth is the narrowest.