特发性黄斑裂孔的光学相干断层扫描图像特征

目的 观察特发性黄斑裂孔的光学相干断层扫描(optical coherence tomography,OCT)图像的形态特征。 方法 对65例直接检眼镜或三面镜检查诊断为特发性黄斑裂孔的患者的70只患眼进行OCT、眼底彩色照相和/或荧光素眼底血管造影(fundus fluorescein angiography,FFA)检查，结合临床特征对OCT图像进行分析。 结果 70只眼中，1，2，3，4期黄斑裂孔分别为11，12，36，11只眼。OCT图像特征1期者表现为黄斑中心凹变浅或消失，神经上皮层浅脱离，中心凹平均厚度为(324.55±139.92)μm；2期者为视网膜表层部分缺失伴小的视网膜组织全层缺损，裂孔的表面有一个可贴附的盖，裂孔平均孔径为(241.75±107.08)μm；3期者为神经上皮层全层缺损，游离盖或无盖，裂孔周围可伴有不同程度囊样水肿，裂孔孔径为(699.78±160.99)μm；4期者图像特征与3期相似，但伴黄斑区和视盘玻璃体后脱离，裂孔孔径(631.36±243.46)μm。 结论 OCT能直观、清晰地显示特发性黄斑裂孔的横截面形态特征，同时能精确地测量裂孔的大小。 (中华眼底病杂志, 1999, 15: 205-208)

Characteristics and quantitative measurement of idiopathic macular holes with optical coherence tomography

Objective To investigate the characteristics of optical coherence tomography (OCT) images in idiopathic macular hole. Methods OCT、color photography and fundus fluorescein angiography were performed in 65 cases(70 eyes) of macular holes and which were then graded by connecting to their clinical characteristics. Results Among the 70 eyes the number of 1～4 stages of macular holes were 11,12,36 and 11 eyes respectively.In eyes of stage 1 OCT images showed flattening or disappearing of fovea and minimally reflective space within or beneath the neurosensory retina;stage 2 showed a full thickness hole with an attached operculum and surrounding edema;stage 3 displayed a full-thickness hole with surrounding edema and stage 4 showed a full-thickness hole and a complete separation of the poterior hyaloid membrane from the retina.The dimeter of the macular holes in stage 2,3 and 4 were (241.75±107.08),(699.78±160.99), (631.36±243.46)μm,respectively. Conclusions OCT can display the characteristics of idiopathic macular holes and measure the diameters of holes quantitatively. (Chin J Ocul Fundus Dis, 1999, 15: 205-208)