海德堡OCT在黄斑区轻度视网膜挫伤中的应用价值

The Application Value of Heidelberg OCT in Mild Macular Blunt Trauma

目的 分析海德堡Spectralis HAR+OCT在黄斑区轻度视网膜挫伤中的应用价值。方法 收集2018年1月至2021年1月在赤峰朝聚眼科医院就诊,确诊为黄斑区轻度视网膜挫伤的34例(34眼)临床资料,包括一般情况、眼科常规检查、眼底彩照、海德堡Spectralis HAR+OCT检查,对其临床特点及OCT影像学表现进行分析。结果 34例患者中,男性23例,女性11例,年龄12~52岁,平均年龄(34.03±9.22)岁,34例患者均因眼球钝挫伤就诊,表现为受伤眼视力下降,视物模糊,病程在2 d之内,最佳矫正视力0.4~1.0,眼底镜检查及眼底彩照均未发现黄斑区明显异常,OCT检查双眼黄斑内环区、中央区与外环区平均视网膜厚度值统计学分析,无统计学意义(P>0.05)。OCT近红外成像定位像上,受伤眼黄斑中心凹周围见细点状低反射,与之对应的断层成像上,表现为黄斑中心凹周围椭圆体带及嵌合体带不规整、轻度隆起,嵌合体带模糊,反射增强,部分病例嵌合体带下见低反射。临床治疗后,随访2~6个月,34例患者视力均恢复至正常,临床症状消失。结论 海德堡Spectralis HAR+OCT近红外成像及断层扫描成像相结合,能清晰显示黄斑区轻度视网膜挫伤,可以为临床提供影像诊断依据,防止漏诊发生。

Objective To analyze the value of Heidelberg Spectralis HAR+OCT in mild macular blunt trauma.Methods Thirty-three cases(Thirty-four eyes) diagnosed as mild macular blunt trauma were retrospectively analyzed. Clinical data including general condition, ocular examination, fundus photography and Heidelberg Spectralis HAR+OCT were collected.Results Of 34 cases, females and males are 11 cases and 23 cases, respectively. The mean age is(34.03±9.22)years(range from 12 to 52 years old). All cases visited for blunt ocular trauma, sharing the same manifestations with blurred vision, decreased visual acuity of the injured eye and course of the disease is within 2 days. The best corrected visual acuity ranged from 0.4 to 1.0, and no markedly abnormal was found both in funduscopy and fundus photography. Besides that, there was no significant difference in the mean retinal thickness in the inner, central and outer macular areas in OCT examination(P>0.05).Small dot-like low reflection appeared around the macular fovea in OCT near-infrared imaging positioning image corresponded to irregular, mild uplift light band of ellipsoid zone and chimera area around macular fovea or enhanced reflection with fuzzy light band of chimeric region in tomography.Low reflection was also found in some cases.During the 2-6 months follow-up period after clinical treatment, all cases were cured.Conclusion The combination of Heidelberg Spectralis HAR+OCT near infrared imaging and tomography can clearly show the occult retinal contusion in the macular area, which can provide the basis for clinical imaging diagnosis and prevent the occurrence of missed diagnosis.