黄斑水肿的光相干断层扫描分析

Optical coherence tomography in macular edema

目的 观察黄斑水肿的光相干断层扫描 (OCT)图像特征 ;探讨黄斑中心凹厚度与最佳矫正视力之间的关系。 方法 对 5 0例正常对照者以及 4 7例 5 4只经直接、间接检眼镜、三面镜及荧光素眼底血管造影 (FFA)诊断为黄斑水肿的患眼进行 OCT检查 ,通过黄斑中心凹的水平或垂直方向线性扫描 ,测量黄斑中心凹的厚度 ,对比分析两组受检者的黄斑形态及中心凹厚度值 ,根据形态学特点对黄斑水肿者的OCT图像进行分类并将其中心凹厚度与其最佳矫正视力进行相关分析。 结果 正常对照组与黄斑水肿组黄斑形态及中心凹厚度差异有显著性的意义。黄斑水肿患眼的 OCT图像表现为 3种特征 ,2 0只眼表现为黄斑区视网膜海绵样肿胀 ,占 37.1% ;2 6只眼表现为黄斑囊样水肿 ,占 4 8.1% ;8只眼表现为浆液性视网膜神经上皮脱离 ,占 14 .8%。黄斑水肿者黄斑中心凹厚度与其最佳矫正视力呈负相关 (r=- 0 .5 6 9,P=0 .0 0 0 )。 结论 黄斑水肿的 OCT图像主要包括视网膜海绵样肿胀、黄斑囊样水肿及神经上皮浆液性脱离。黄斑水肿患者的黄斑中心凹厚度明显增厚 ,黄斑中心凹厚度越厚 ,视力越差。

Objective To observe the characteristics of the images of optical coherence tomography (OCT) performed on the patients with macular edema, and investigate relationship between the retinal thickness at the central fovea and the best-corrected visual acuity. Methods Fourty-seven patients (54 eyes) with macular edema diagnosed by direct and indirect ophthalmoscopy, three mirror contact lens, or fundus fluorescein angiography (FFA) underwent OCT which was also performed on 50 healthy individuals as the control. The examination focused on the horizontal and vertical planes crossing the central fovea to measure the thickness of the fovea. The correlation between retinal thickness at the central fovea and best-corrected visual acuity was analyzed, and the images of OCT in the patients with macular edema were classified according to the macular configuration. Results Significant difference of the macular configuration and best-corrected visual acuity was found between the control and macular edema group. Three characteristics were found in the images of OCT in the patients with macular edema: sponge-like retinal swelling in 20 eyes (37.1%), macular cystoid edema in 26 eyes (48.1%), and serous retinal detachment in 8 eyes (14.8%). The statistical analysis showed that there was a negative correlation between the thickness at the central fovea and best-corrected visual acuity of affected eyes (r=-0.569, P=0.000). Conclusions The images of OCT in macular edema include 3 types: sponge-like retinal swelling, macular cystoid edema, and serous retinal detachment. The retinal thickness at the central fovea of the eyes with macular edema was thicker than that of the normal ones, and the thicker the fovea is, the poorer the visual acuity will be.