海德堡视网膜断层扫描仪黄斑区视网膜分析系统与OCT对黄斑水肿的诊断价值

The diagnostic value of Heidelberg retina tomographⅡmacular edema module and OCT for macular edema

目的探究海德堡视网膜断层扫描仪(HRT-Ⅱ)的黄斑区视网膜分析系统(MEM)与光学相干断层扫描(OCT)对黄斑水肿(ME)的诊断价值。方法选取2018年3月-2019年3月本院收治的72例(137只眼)视网膜静脉阻塞(RVO)和糖尿病视网膜病变(DR)患者,根据荧光素眼底血管造影(FFA)结果将患者分为ME组(34例64只眼)和非ME组(38例73只眼),另收集正常志愿者25例(46只眼)为对照组,采用HRT-Ⅱ检查受试者的视网膜中心部水肿指数(e1)和视网膜外环部水肿指数(e2);采用OCT检查受试者的黄斑中心凹视网膜厚度(CRT)和黄斑中心凹下脉络膜厚度(SFCT);将HRT-Ⅱ和OCT的结果与FFA诊断结果进行比较,分析二者对ME的诊断价值。结果ME组、非ME组和对照组的e1、e2值比较,差异均有统计学意义(P<0.05);其中,ME组的e1、e2值大于非ME组和对照组(P<0.05);非ME组和对照组的e1、e2值比较,差异无统计学意义(P>0.05);ME组、非ME组和对照组的CRT值有明显差异(P<0.05);其中,ME组的CRT值大于非ME组和对照组(P<0.05),非ME组和对照组的CRT值及3组的SFCT值比较,差异无统计学意义(P>0.05);HRT-Ⅱ和OCT检测的ME检出率比较,差异无统计学意义(P>0.05);ROC曲线分析结果显示,HRT-Ⅱ和OCT检测对ME均有诊断价值,其ROC曲线下面积(AUC)分别为0.758、0.838,对ME的诊断均具有统计学意义(P<0.001)。结论HRT-Ⅱ的MEM模块中的e值、OCT中的CRT值可用于量化评估ME,OCT对ME的临床诊断价值高于HRT-Ⅱ。

Objective To investigate the diagnostic value of Heidelberg retina tomographⅡ(HRT-Ⅱ)macular edema module(MEM)and optical coherence tomography(OCT)for macular edema(ME).Methods 72 patients(137 affected eyes)with retinal vein occlusion(RVO)and diabetic retinopathy(DR)who were admitted to the hospital between March 2018 and March 2019 were selected as the subjects.They were divided into ME group(34 cases with 64 affected eyes)and non-ME group(38 cases with 73 affected eyes)according to the results of fluorescein fundus angiography(FFA).25 normal volunteers(46 eyes)were recruited as the control group.The retinal center edema index(e1)and outer retinal edema index(e2)were determined by HRT-Ⅱ.The central retinal thickness(CRT)and subfoveal choroidal thickness(SFCT)were measured by OCT.The results of HRT-Ⅱand OCT were compared with the diagnosis results of FFA,and the diagnostic value of the two for ME was analyzed.Results There were statistically significant difference in e1 and e2 values between ME group,non-ME group and the control group(P<0.05).The e1 and e2 values in ME group were larger than those in non-ME group and control group(P<0.05),but there was no statistically significant difference between non-ME group and the control group(P>0.05).There were statistically significant difference in CRT between ME group,non-ME group and the control group(P<0.05).The CRT in ME group was larger than that in non-ME group and control group(P<0.05),but there was no statistically significant difference between non-ME group and the control group(P>0.05).There was no statistically significant difference in the detection rate of ME between HRT-Ⅱand OCT(P>0.05).ROC curve analysis showed that both HRT-Ⅱand OCT had diagnostic value for ME,and the areas under ROC curve(AUC)were 0.758 and 0.838,respectively(P<0.001).Conclusion The e value of HRT-ⅡMEM and CRT measured by OCT can be used for quantitative evaluation of ME.The clinical diagnostic value of OCT for ME is higher than that of HRT-Ⅱ.