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1.
特发性黄斑裂孔的光学相干断层成像分析   总被引:1,自引:1,他引:0  
王风华  李彬  李宁东  王光璐  熊颖 《眼科》2002,11(4):218-220
目的:采用光学相干断层扫描(optical coherence tomography,OCT)观察特发性黄斑裂孔(idiopathic macular hole,IMH)各期的图像特征及演变过程。方法:对199只眼(170例,其中29例双眼患者)IMH的OCT图像进行回顾性观察分析,进行随访观察。结果:Ⅰ期裂孔16只眼(8%),表现为黄斑中心凹视网膜不同程度的囊样变性(75%)或浅脱离(15%);Ⅱ期裂孔20只眼(10%),OCT示黄斑中心凹旁中心破裂(85%)和中心破裂(15%);Ⅲ期裂孔121只眼(61%),表现为黄斑中心凹神经上皮层全层缺失;Ⅳ期裂孔、板层裂孔及双眼黄斑裂孔分别为23只眼(12%)、19只眼(10%)、29只眼(17%)。结论:OCT图像对观察IMH各期特征及演进过程具有重要的临床应用价值。  相似文献   

2.
目的探讨光学相干断层扫描图像(OCT)在巩膜扣带术后黄斑形态检测中的意义。方法应用Zeiss-Humphery OCT检查仪对30例(31只眼)经巩膜扣带术复位成功的患者黄斑区进行经中心凹水平和垂直扫描,观察黄斑形态,并测量中心凹处神经上皮厚度。结果共31只眼接受检查,黄斑区结构正常11只眼,神经上皮平均厚度为(149.54±12.58)μm,黄斑结构异常20只眼,检测异常率为64.5%,其中黄斑区视网膜水肿3只眼,中心凹神经上皮变薄5只眼,黄斑区色素上皮脱离6只眼,视网膜前膜和皱折4只眼,黄斑全层裂孔和视网膜出血各1只眼。OCT能观察术后黄斑结构的变化,并与术后视力存在一定关系。结论OCT能精确探查视网膜复位术后黄斑结构的变化,并且在病变的定量随访中有重要意义。  相似文献   

3.
李宁东  李彬  王凤华  王光璐  熊颖  严伟 《眼科》2002,11(6):345-347,I011
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应用。方法:选取2000年9月-2001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22例28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:22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,28只临床怀疑黄斑裂孔的眼中,20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;28只眼中,21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。  相似文献   

4.
Stargardt病的光学相干断层扫描图像特征   总被引:4,自引:0,他引:4  
Stargardt病是遗传性黄斑营养不良中最常见的一种,其临床和荧光素眼底血管造影(fundusfluoresceinangiography,FFA)表现已为大家所熟知。近年来我们采用光学相干断层扫描(opticalcoherencetomography,OCT)技术,对8例Stargardt病患者的黄斑区进行观察,OCT图像显示出神经上皮层变薄消失等改变。现报告如下。1 对象与方法1.1 对象 我院门诊确诊的Stargardt病患者8例16只眼,男女各4例,年龄8~35岁,平均23.7岁。视力…  相似文献   

5.
黄斑裂孔视网膜脱离术后视功能恢复的观察   总被引:2,自引:0,他引:2  
本文对30例单眼罹患视网膜脱离经手术获得成功而另眼为健眼的病人,就黄斑裂孔视网膜脱离术后视功能恢复进行探讨。用Octopus视野分析仪检查,健眼为对照眼。结果:术后30只眼视野的定量值,MS比术前提高,而MD、CLV比术前下降,差异呈显著性(P<0.0001)。随访6个月以上,术后视力与术前视力对照,有明显提高(P<0.05)。结论:黄斑裂孔视网膜脱离术后视功能恢复与裂孔大小、脱离的范围有关。术后黄斑功能不能完全恢复。  相似文献   

6.
目的:应用光学相干断层成像术(optical coherence tomography,OCT)测量我国正常人贡斑视网膜神经上皮层(retinal neurosensory layer)和色素上皮层(retinal pigmet epithelium,RPE)与脉络膜毛细血管层的厚度。方法:用OCT对60例(120眼)正常人进行经黄斑中央小凹水平和垂直扫描,扫描长度4mm,测量并计算黄斑中央小凹;  相似文献   

7.
黄斑裂孔手术   总被引:4,自引:1,他引:3  
颜华  Leland  Dhurj 《眼科新进展》1998,18(2):74-76
目的:评价转移生长因子(TGFb)、自体血清、或无眼内填充物治疗黄斑裂孔的手术成功率。 方法对44例50只眼行玻璃体切割手术联合后部玻璃体脱离治疗黄斑裂孔。15只眼术中用TGFb,其中包括 3 只眼初次手术失败,20只眼用自体血清,15只眼术中无任何填充物。 结果50只眼中35只眼(70%)黄斑裂孔手术成功,其中 TGFb组 15只眼(100%),自体血清组11只眼(55%),无填充物组 9只眼(60%)手术成功(P<0.05)。 TGFb组术后视力均提高(P<0. 05)。术后并发症包括晶体核硬化 (11只眼, 22%),视网膜脱离(2 只眼,4%),眼压高于 4. 00kPa并持续1wk以上(7 只眼, 14%),自体血清组有 1例术后1wk发生感染性眼内支。 结论TGFb对治疗黄斑裂孔有显著作用。  相似文献   

8.
光学相干断层成像对黄斑裂孔的诊断意义   总被引:1,自引:0,他引:1  
目的 评价光学相干断层成像 (optical coherence tomography,OCT)对黄斑裂孔的诊断价值。方法 自 1999年 10月至 2 0 0 0年 2月我院 40例 45只眼临床诊断为黄斑裂孔的患者在双眼散瞳后行 OCT检查 ,并对图像进行测量和分析。结果  10例 (13只眼 ) OCT显示为板层裂孔 ,其黄斑中心凹处神经上皮厚度平均为 110μm,标准差为 41。全层黄斑裂孔 30例 (32只眼 ) ,5例为双眼黄斑全层或板层裂孔 ,平均裂孔直径为 6 2 1.2μm,标准差为194.1。全层裂孔者 OCT表现为黄斑中心凹处边界清晰的全层神经上皮缺失 ,裂孔周围视网膜增厚为 393.4±10 0 .7μm,并见无反射的暗腔。 5例行手术后裂孔封闭 ,黄斑中心凹正常反射曲线恢复。结论  OCT是一种非接触性、非侵入性、高分辨率的检测技术 ,临床上对于黄斑裂孔的定性及定量诊断具有非常重要的应用价值。  相似文献   

9.
自体浓缩血小板在黄斑裂孔手术中的作用   总被引:4,自引:0,他引:4  
为探寻增视的黄斑裂孔封闭方法,对黄斑裂孔43眼(包括特发性黄斑裂孔20眼,外伤性黄斑裂孔6眼,黄斑裂孔视网膜脱离17眼),玻璃体切除术后采用自体浓缩血小板封孔20~30%SF6注入。结果:术后视力>0.1者:特发性黄斑裂孔为100%,外伤性黄斑裂孔为83.3%,黄斑裂孔视网膜脱离为41.2%。术后最好视力:特发性黄斑裂孔为1.0,外伤性黄斑裂孔为0.2,黄斑裂孔视网膜脱离为0.2。结论:自体浓缩血小板用于黄斑裂孔的封闭是可行的,有效的。  相似文献   

10.
目的 评价氪黄激光治疗黄斑裂孔的临床疗效和价值。方法 用氪黄激光治疗高度近奶黄斑裂孔(14例)和外伤性黄斑裂孔(3例)共17例(17眼)。术后平均随访18.4个月。结果 13例裂孔封闭,1例无效;3例发生视网膜脱离,均为高度近视眼黄斑裂孔;3例外伤性黄斑裂孔有2例出现旁中心暗点。术后视力:3例增加,9例不变,5例下降。结论 氪黄激光治疗黄斑裂孔相对较安全,并有一定价值,但病例选择宜慎重。  相似文献   

11.
AIMS: To image the vitreoretinal interface and provide further information on the pathogenesis of idiopathic macular hole formation. METHODS: Prospective recruitment of 80 eyes of 41 consecutive patients referred with a diagnosis of idiopathic full thickness macular hole (FTMH) to a teaching hospital retinal clinic. Both eyes of each patient underwent optical coherence tomography (OCT) imaging with vertical and horizontal scans centred on the fovea. RESULTS: A total of 30 eyes had stage 2 or 3 FTMHs and, of these, 21 had persistent vitreofoveal attachment and associated prefoveal opacities. 18 prefoveal opacities were identified by Goldmann contact lens examination and confirmed on OCT examination. Three prefoveal opacities were identified only on OCT examination. 10 eyes had stage 4 FTMHs and four cases were identified in whom the OCT appearance was consistent with impending, aborted, or lamellar macular holes. CONCLUSIONS: The wide range in OCT appearance of macular holes and associated prefoveal opacities suggests that, in at least some cases, a significant amount of retinal tissue is torn from the foveal area during macular hole formation. OCT imaging provides additional information on macular hole pathogenesis and is valuable in the planning of surgical intervention.  相似文献   

12.
特发性黄斑裂孔患者玻璃体后脱离的相干光断层成像特征   总被引:1,自引:0,他引:1  
Dai H  Li Y  Long L  Di Y  Lu Y  Wang Z 《中华眼科杂志》2002,38(11):667-669,I003
目的 观察特发性黄斑裂孔患者玻璃体后脱离的相干光断层成像(optical coherence tomography,OCT)特征,探讨裂孔的发生与玻璃体后脱离间的关系。方法 对临床确诊的特发性黄斑裂孔患者193例(223只眼)进行OCT检查,分析其玻璃体后脱离的发生及发展。结果 按Gass分期标准,I-Ⅳ期裂孔分别为21,74,97有31只眼,在Ⅰ,Ⅱ,Ⅲ期裂孔眼中,OCT图像显示玻璃体与视网膜分离者分别有15(71.4%),38(51.4%)及46只眼(47.4%)。其表现形式有3种:(1)黄斑中心凹周围视网膜与玻璃体发生分离,但中心凹部相连,此处视网膜神经上皮层被牵起,层间出现囊腔;(2)玻璃体附着于未完全游离的视网膜裂孔盖处,使盖膜牵引上翘;(3)玻璃体完全与后极部视网膜分离,表现可见与其平行的玻璃体后介膜。这3种表现形式分别于Ⅰ,Ⅱ,Ⅲ期裂孔。在随诊的部分患眼中,OCT图像显示出I期进展至Ⅲ期裂孔的过程,并见玻璃体后脱离的裂孔自行愈合现象。在组合的OCT图像中,显示黄斑中心凹部与视乳头和颞侧视网膜之间脱离的玻璃体事 于现凹隆圆顶盖样图形。结论 OCT检测结果证实玻璃体与黄斑中心凹发生分离的过程与黄斑裂孔进展的过程相一致,提示黄斑裂孔的形成及发展与玻璃体后脱离的发生密切相关。  相似文献   

13.
外伤性黄斑裂孔的光学相干断层成像特征   总被引:2,自引:0,他引:2  
目的 :分析外伤性黄斑裂孔的光学相干断层成像特征。方法 :18例黄斑裂孔患者 (18眼 )行OCT检查。结果 :17例外伤性黄斑裂孔均未见玻璃体后脱离 (PVD) ,裂孔边界整齐 ,无明显视网膜脱离。 7例裂孔边缘可见神经上皮脱离的轮化 ,10例未见晕轮。结论 :年轻的外伤性黄斑裂孔患者不易发生视网膜脱离 ,定期检查OCT有助于外伤性黄斑裂孔治疗方式的选择。  相似文献   

14.
Scanning laser tomography of full thickness idiopathic macular holes   总被引:2,自引:0,他引:2  
AIM: We used a retinal tomographic analyser to study the profile of the retinal surface in patients with stage 3 and 4 idiopathic macular holes, to attempt to elucidate the direction of forces present. METHODS: The Heidelberg retina tomograph was used to acquire a three-dimensional tomographic image of the macula in each eye of 21 consecutive patients with full thickness macular hole. RESULTS: The surface profile showed an elevated rim around the 24 macular holes imaged, with a gently sloping outside edge and a steeply sloping inside edge. In addition, a ring of elevated tissue around the edge of the hole was observed in all the holes and also in two of the fellow 'normal' eyes. This ring of elevated tissue was presumed to represent a ring of persistent vitreo-retinal traction around the fovea in the presence of a perifoveal posterior vitreous detachment. This is consistent with antero-posterior traction persisting in stage 3 and 4 full thickness macular holes. The mean ring diameter was 480 mum, when present in the fellow eye but was 950 microm in the presence of a macular hole, which we argue is suggestive of centrifugal displacement of retinal tissue on the formation of a stage 3 macular hole and provides evidence for tangential traction. CONCLUSION: We suggest that antero-posterior traction forces are the primary cause of full thickness macular holes, with these forces persisting in stage 3 and 4 macular holes, while tangential forces serve to enlarge the hole at this later stage.  相似文献   

15.
PURPOSE: To describe optical cross-sectional images of successfully repaired idiopathic macular holes and to determine the influences of epiretinal membranes and retinal pigment epithelial (RPE) changes on foveal reconstruction and the correlation between retinal thickness and postoperative visual acuity. METHODS: In a prospective study, optical cross-sectional imaging and retinal thickness measurement of the macula using a retinal thickness analyzer were performed on 63 eyes of 63 patients who underwent successful macular hole surgery. RESULTS: Cross-sectional images of foveal reconstruction were morphologically categorized into four patterns: normal fovea (23 eyes [37%]), cavernous fovea (19 eyes [30%]), flat fovea (11 eyes [17%]), and irregular fovea (10 eyes [16%]). Epiretinal membranes were observed in the last two groups (55% and 40%) and RPE changes were observed only in the irregular fovea group (16%). The mean retinal thickness of the fovea in all eyes was 213 +/- 92 microm (mean +/- SD; range, 93-570 microm), which varied significantly (P < 0.001) among the four groups. Linear regression analysis showed a significant correlation between retinal thickness at the fovea and logarithmic converted visual acuity (R2 = 0.42, P < 0.001). CONCLUSIONS: Structural features of foveal reconstruction following successful macular hole surgery involved four patters: normal fovea, cavernous fovea, flat fovea, and irregular fovea. Retinal thickness of the fovea, which varied among the groups, correlated with postoperative visual acuity. Postoperative epiretinal membrane formation and RPE damage may disturb normal foveal reconstruction and visual recovery.  相似文献   

16.
特发性黄斑视网膜前膜的光学相干断层扫描   总被引:29,自引:14,他引:15  
目的观察特发性黄斑视网膜前膜(idiopathic macular epireti nal membranes, IMEM)的光学相干断层扫描(optical coherence tomography, OCT)图像 特征,探讨IMEM患眼黄斑中心凹厚度与视力之间的关系。方法对67例73只经直接或间接检眼镜、三面镜、眼底彩色照相或荧光素眼底血管造影(fundus fluorescein angiogrphy, FFA)检查诊断为IMEM的患眼进行经黄斑中心凹的OCT线性扫描, 测量黄斑中心凹厚度,并与视力进行相关分析。结果32只眼表现为视网膜前膜(Epiretinal menmbrabces, ERMs)伴黄斑水肿;20只眼表现为增生性ERMs,14只眼表现为ERMs伴假性黄斑裂孔;7只眼表现为ERMs伴板层黄斑裂孔。73只眼中27只眼可见ERMs与视网膜内层分离,占38.36%。增生性ERMs者黄斑中心凹厚度 最厚,ERMs伴板层黄斑裂孔者黄斑中心凹厚度最薄。黄斑中心凹厚度与视力呈负相关(r=-0.454,P=0.000)。结论IMEM 的 OCT图像主要有ERMs伴黄斑水肿、增生性ERMs、ERMs伴假性裂孔与板层裂孔改变;ERMs患者黄斑中心凹厚度越厚视力越差。(中华眼底病杂志,2001,17:115-118)  相似文献   

17.
LiuX  LingYL 《眼科学报》2002,18(1):14-19
OBjectives:To study the characteristics of optical coherence tomography(OCT) in idiopathic macular epiretinal membranes(IMEM)and the relationship between the thickness of fovea and the vision of affected eyes.Methods:A total of 67 cases(73 eyes)with clinical diagnisis of IMEM using direct indirect ophthalmoscope,three mirror contact lens,fundus color photography or nfundus fluorescein angiography(FFA) were examined with OCT.Results:Epiretinal membranes(ERMs)with macular edema were found in 32 eyes, proliferative ERMs in 20 eyes,ERMs withmacular pseudoholes in 14 eyes and ERMs with laminar macular holes in 7eyes.Based on OCT,the ERMs were clearly and partially seperated from the retinal (27 eyes,38.36%),the retinal thickness of the fovea was the thickest in the proliferative ERMs and the thinnest in the ERMs with laminar macular holes.The statistical analysis showed there was a negative correlation between the thickness of fovea and visual acuity (r=-0.454,P=0.000).Conclusion:There were four types of images of OCT in IMEM:ERMs with macular edema,proliferative ERMs,ERMs with macular pseudohole and ERMs with laminar macular hole;and the thicker the fovea under the OCT,the poorer the vision acuity in the affected eyes with ERMs.  相似文献   

18.
黄斑水肿的光相干断层扫描分析   总被引:8,自引:0,他引:8  
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50例正常对照者以及47例54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,20只眼表现为黄斑区视网膜海绵样肿胀,占37.1%;26只眼表现为黄斑囊样水肿,占48.1%;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=-0.569, P=0.000)。 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。 (中华眼底病杂志,2004,20:152-155)  相似文献   

19.
OBJECT: To clarify the morphologic features and foveolar traction in macular hole development and macular pseudohole. METHODS: The vitreoretinal tomography of idiopathic macular holes and macular pseudoholes was observed with optical coherence tomography (OCT). RESULTS: In stage 1 and 2, foveolar intraretinal splitting was evident. The posterior hyaloid membrane was detected in 7 of 10 eyes with stage 1 and 2 holes. Dome-shaped vitreoretinal separation was seen in 6 of 7 eyes in which the posterior hyaloid membranes were detected. A complete posterior vitreous detachment was seen around a stage 3 hole. In the macular pseudohole with preretinal membrane, there was anterior and central displacement of the inner retina in the perifoveal region, resulting in a U-shaped deformation of the macular lesion. In contrast, the structure of the central fovea was virtually intact. CONCLUSIONS: On the basis of the OCT findings, the intraretinal splitting and the cyst formation are important features in the development of a macular hole. The dome-shaped vitreoretinal separation in the early stages of macular holes suggests that the posterior hyaloid membrane may not be taut but slack, and would not cause a tractional force continuously even in early-stage macular holes.  相似文献   

20.
PURPOSE: To evaluate successful macular hole surgery using optical coherence tomography (OCT) and multifocal electroretinography (MFERG). DESIGN: Interventional case series. METHODS: In a prospective study, 20 eyes of 20 patients with successful surgery for stage II, III, or IV idiopathic macular hole were evaluated by best-corrected visual acuity (BCVA), ocular examination, OCT, and MFERG preoperatively and 1, 3, 6, and 12 months postoperatively. For statistical analysis, the paired t test and nonparametric methods were used, as well as the Spearman analysis. RESULTS: Postoperatively, all 20 eyes of 20 patients had anatomic closure of the macular hole confirmed by OCT. The center of the fovea, measured by OCT from the retinal pigment epithelium to the inner retinal surface, had a mean +/- SD thickness of 116.5 +/- 30.9 microm (range, 68-175 microm) 1 year postoperatively. Best-corrected visual acuity significantly improved (preoperative mean +/- standard deviation [SD] value, 0.131 +/- 0.081 and 1 year postoperative mean +/- SD value, 0.407 +/- 0.193). Multifocal electroretinography values area 1 (0-2.8 degrees) and area 2 (2.8-9 degrees from the center of the fovea) significantly improved (preoperative mean +/- SD values 3.10 +/- 1.334 nV/deg(2) and 3.573 +/- 1.545 nV/deg(2), respectively, and 1 year postoperative +/- SD mean values, 5.53 +/- 1.208 nV/deg(2) and 4.748 +/- 1.404 nV/deg(2), respectively). The thickness of the fovea, measured by OCT, significantly correlated with the BCVA 1 year postoperatively. One year postoperative MFERG values areas 1 and 2 were not correlated with 12-month BCVA and OCT findings. CONCLUSIONS: Twelve months postoperatively BCVA and MFERG values significantly improved in this series of eyes with successful macular hole surgery. Optical coherence tomography findings were correlated to BCVA, but MFERG values were not correlated to BCVA and OCT findings, 1 year postoperatively.  相似文献   

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