非常态虹膜结构患者行超广角眼底成像检查

Countermeasures of the Ultra-Widefield Scanning Laser Ophthalmoscope in Patients with an Abnormal Iris Structure

目的: 探讨利用操作者调动眼位的方法,对虹膜不完整及虹膜存在其他视觉标志物的非常态虹膜结构患者采用欧堡超广角眼底成像技术进行眼底检查的方法。方法: 系列病例研究。采用操作者调动眼位的方法,对2020年3月27日-8月11日在中国医科大学附属第一医院行欧堡超广角眼底成像术的29例(29眼)非常态虹膜结构患者进行眼底检查。其中虹膜小梁切除术后患者8例(8眼),虹膜根切激光术后患者10例(10眼),眼底玻璃体切割术行Ando孔患者7例(7眼),虹膜色素痣患者4例(4眼)。结果: 调整患者眼位,使虹膜再造结构的孔窗方向处于检查面的一侧,而瞳孔位于检查面的主体后,纳入研究的29例(29眼)非常态虹膜结构患者均能够顺利采集到眼底影像,且全部4种疾病的眼底采集的图像范围可达的平均象限数为2.93,达到近似于广角的范围(60°~100°眼底范围),基本可以满足临床眼底检查的需要。结论: 采用操作者调动眼位的方法可以对非常态虹膜结构患者进行超广角眼底检查,且获得的眼底图像范围要高于普通眼底检查,扩大了超广角眼底检查的适应证范围。

Objective:To study how to use the ultra-widefield scanning laser ophthalmoscope and the operator to move the position to perform fundus examinations on patients with an abnormal iris structure whose iris is incomplete and whose iris has other visual markers.Methods:In this case series study,twenty-nine patients(29 eyes),who underwent ultra-widefield scanning laser ophthalmoscopy in the First Affiliated Hospital of China Medical University from March 27,2020 to August 11,2020,were examined with the eye position adjustment method.Among the 29 cases,there were 8 cases(8 eyes)after trabeculectomy,10 cases(10 eyes)after laser rhizotomy,7 cases(7 eyes)after vitrectomy and 4 cases(4 eyes)with iris pigmented nevus.Results:After adjusting the eye position of the patients,so that the direction of the iris reconstruction structure is on one side of the examination surface,and the pupil is on the main body of the examination surface,fundus images were successfully acquired in all 29 patients(29 eyes)with abnormal iris.And the average number of quadrants of fundus images of all four diseases was 2.93,and the images reached the approximate wide-angle range(about 60°-100°fundus range),that can basically satisfy the needs of a clinical fundus examination.Conclusions:The method of adjusting the eye position by the operator can be used for ultra wide angle fundus examination of patients with abnormal iris structure,and the range of fundus image obtained is higher than that of ordinary fundus examination,which expands the scope of indications of orburg examination.