光学相干断层成像术在诊断高度近视眼合并黄斑裂孔中的应用

Diagnosis of macular holes in high myopia with OCT

目的 :探讨光学相干断层成像术 (OCT)在诊断高度近视眼合并黄斑裂孔中的作用。方法 :选取 2 0 0 0年 9月～2 0 0 1年 5月在门诊就诊的高度近视眼患者怀疑黄斑裂孔的病例 2 2例 2 8只眼进行OCT检查 ,散瞳后 ,选用 4mm长的扫描线对黄斑进行线性扫描。结果 :2 2例高度近视眼患者中 ,眼底检查均有不同程度的后极部脉络膜萎缩灶 ,其中 12人 16只眼伴有后巩膜葡萄肿 ;2 8只临床怀疑黄斑裂孔的眼中 ,2 0只眼黄斑全层裂孔 ,3只眼为板层孔 ,3只眼为黄斑囊样变性 ,2只眼为黄斑裂孔合并黄斑前膜 ;2 8只眼中 2 1只眼伴有不同程度的视网膜脱离。结论 :OCT作为一种新型的临床检查手段 ,对于高度近视眼合并黄斑裂孔的早期诊断和鉴别诊断 ,监测病情转归 ,以及选择治疗手段 ,具有重要的临床应用意义。

Objective:To assess the potential value of optical coherence tomography(OCT) for diagnosing the macular hole in high myopia.Methods:Optical coherence tomography was used to examine 22 high myopia patients(28 eyes) referred from the clinic for the possible existence of macular holes.After dilation of pupill,linear scans with 4 mm length were performed,and OCT images were analyzed.Results:All the patients had various extents of chorioretinal atrophy and 12 patients (16 eyes) also had posterior staphyloma.The diagnoses of the 28 eyes examined with OCT were as following:full-thickness macular hole (22 eyes),lamellar hole (3 eyes),macular hole with epimacular membrane (2 eyes),macular cystoid degeneration (3 eyes).Retina detachment occurred in 21 eyes with full-thickness macular holes.Conclusions:Optical coherence tomography is an useful and reliable technique for diagnosing the macular holes in high myopia.