OCT在视网膜中央动脉阻塞中的应用及意义

目的：探讨光学相干断层扫描(optical coherence tomography，OCT)在视网膜中央动脉阻塞疾病中的应用及内层视网膜厚度与患者治疗前后视力是否存在相关性。

方法：回顾性分析视网膜中央动脉阻塞患者11例，收集患者发病至入院时间、初始视力、治疗后视力，行黄斑OCT测量黄斑区视网膜厚度，进行定量测定和分析黄斑中心凹、距中心小凹3mm及6mm上、下、鼻、颞侧扇形面积下视网膜全层的平均厚度。内层视网膜厚度采用人工手动测量。距黄斑中心小凹1mm处内层视网膜，鼻侧记为N1，颞侧记为T1，距黄斑中心小凹3mm处内层视网膜，鼻侧记为N3，颞侧记为T3。

结果：8/11的患者视力均有不同程度的提高； 患眼黄斑中心凹及鼻侧3mm扇形面积下视网膜全层厚度比健眼增厚(P<0.05)，余各区域面积下视网膜全层厚度与健眼相比无统计学差异(P>0.05)； 患眼N1、N3及T3均比健眼增厚(P<0.05)； 黄斑中心凹厚度患眼与健眼的差值与治疗后视力呈负相关，r=-0.740(P<0.05)； 患眼与健眼N1、T1、T3的差值与治疗后视力呈负相关，r_N1=-0.692，r_T1=-0.754，r_T3=-0.657(P<0.05)。

结论：OCT检查对视网膜中央动脉阻塞患者治疗后视力的恢复有提示作用。

Application and significance of OCT in central retinal artery occlusion

AIM: To investigate the applicationof the optical coherence tomography(OCT)in the central retinal artery occlusion(CRAO)disease, and explore whether is a correlation between inner retinal thickness and visual acuity pre and post treatment.

METHODS: A retrospective analysis of patients with central retinal artery occlusion in 11 cases. Patients' onsets to admission time, initial visual acuity, after-treatment visual acuity were collected. Retinal thickness in the macular area was measured with OCT. Retinal mean thickness of fovea, including macular fovea, the 1mm and 3mm up, down of the fovea, nasal and temporal side to the foveal pit, was measured and analyzed. The thickness of inner retinal layer was measured manually. In the inner retinal layer, 1mm nasal and temporal side to the foveal pit, nasal and temporal side was N1, T1 respectively; 3mm nasal and temporal to the foveal pit, nasal and temporal side was N3, T3 respectively.

RESULTS: The visual acuity of 8/11 patients was improved in different degree. The unhealthy eyes macular area and nasal 3mm retinal mean thickness were thicker than the healthy eye(P<0.05). Compared with the healthy eyes, the unhealthy eyes which retinal thickness under others macular area have no statistical difference(P>0.05). The unhealthy eyes were thicker than the healthy at N1, N3 and T3(P<0.05). The different values that thickness in the fovea of healthy and unhealthy eyes had a negative correlation with visual acuity of after treatment, r=-0.740(P<0.05). The different values of N1, T1 and T3 in healthy and unhealthy eyes also had a negative correlation with visual acuity of after treatment, r_N1=-0.692, r_T1=-0.754, r_T3=-0.657(P<0.05).

CONCLUSION: OCT examination has suggestive function for the recovery of patients with central retinal artery occlusion of visual acuity after-treatment.