黄斑裂孔的光学相干断层成像分析

目的 探讨黄斑裂孔的光学相干断层成像（ｏｐｔｉｃａｌ ｃｏｈｅｒｅｎｃｅ ｔｏｍｏｇｒａｐｈｙ,ＯＣＴ）特征及ＯＣＴ临床应用价值。方法 １９９８年９～１２月临床诊断为黄斑裂孔者共３５例（３８只眼）。经双眼散瞳后进行ＯＣＴ检查,对获取的图像进行分析和测量。结果 １例（１只眼）ＯＣＴ显示为玻璃牵引：１例（１只眼）为黄斑前膜所致的性裂孔：３３例（３６只眼）为黄斑裂孔,其中３例累及双眼。３６只眼中,板层黄

Optical coherence tomography of macular holes

OBJECTIVE: To study the characteristics and clinical application value of the optical coherence tomography (OCT) of macular holes. METHOD: A total of 35 patients with the clinical diagnosis of macular hole were examined with OCT between September and December 1998. OCT imaging was conducted through a dilated pupil, and the OCT images were analyzed and measured. RESULTS: Of the 35 patients examined with OCT, there were pseudohole and epimacular membrane in one eye, vitreofoveal traction in one eye, macular holes in 36 eyes, and 3 patients had macular hole in bilateral eyes. In 4 eyes, there were partial-thickness macular holes, and the defect of partial thickness of neural epithelium in the fovea without halo of retinal detachment was shown in the OCT image. In 32 eyes, there were full-thickness holes; the OCT displayed complete losing of the whole thickness of the neural epithelium in the fovea, sharp edge of the hole and the halo of retinal detachment around the hole. Sometimes nonreflective cavities could be seen within the retina, and the retinal thickness around the hole was increased. According to Gass stage classification of macular hole, there were 2 eyes with impending hole, 3 eyes in stage 2, 15 eyes in stage 3 and 6 eyes in stage 4. 4 eyes underwent vitrectomy. The OCT imaging after the surgery demonstrated the closure of hole and the disappearance of halo surrounding the hole. Through quantitative measurement, the diameter of the hole was (565.88 +/- 40.35) microm, the diameter of the halo was (1,338.76 +/- 147.57) microm, and the retinal thickness surrounding the hole was (391.87 +/- 18.97) microm. The sizes of the hole and the halo and the retinal thickness around the hole were correlated with the vision. CONCLUSION: OCT is a novel noninvasive, noncontact imaging technique. It is helpful in the diagnosis and differential diagnosis of the macular hole; the progress of the hole can be quantitatively estimated, and it is also helpful in selection of operation and assessment of operative therapeutic effects.