糖尿病性黄斑水肿OCT和FFA形态学分类的对比分析

目的探讨糖尿病性黄斑水肿相干光断层扫描(OCT)和眼底荧光素血管造影(FFA)的形态学特征、分类及相互关系。设计前瞻性病例系列。研究对象临床有意义糖尿病性黄斑水肿(CSME)患者102例177眼。方法分别对CSME组患者进行OCT及FFA检查,观察两种分类之间的相互关系,并与中心凹中心厚度、最佳矫正视力等临床资料进行对比分析。主要指标CSME患者的OCT及FFA类型、中心凹中心厚度、最佳矫正视力。结果FFA分类的局限水肿型在OCT1型中所占的比例为70.6%,高于弥漫水肿型(27.2%)和囊样水肿型(2.2%)(P<0.05)。FFA弥漫水肿型在OCT2型中占47.9%,明显高于局限水肿型(25.0%)和囊样水肿型(27.1%)(P<0.05)。FFA分类的囊样水肿型在OCT3型(3A型 3B型)中占56.8%,明显高于局限水肿型(10.8%)和弥漫水肿型(32.4%)(P<0.05)。OCT1型及FFA局限水肿型的矫正视力最好,黄斑中心凹中心厚度值最小(P<0.05)。结论CSME患者OCT与FFA的形态学类型密切相关。结合两种检查方法,可更加全面地反映CSME患者黄斑区视网膜的变化,为揭示糖尿病性黄斑水肿的病理机制、寻求每种类型的最佳治疗方案提供参考。     

糖尿病黄斑病变分型和视力预后

目的 分析317例597只眼糖尿病黄斑病变荧光形态并进行分型,探讨类型和分期与视力预后的关系。 方法 每例均作双眼荧光素眼底血管造影,分析黄斑区荧光素渗漏的来源,形态和范围。黄斑拱环的大小及黄斑区是否有无灌注区存在,有无增生等。 结果 ①597只眼中无渗漏型154只眼占25.8,局部水肿型188只眼占31.5%,弥漫水肿型239只眼占40.0%,缺血型12只眼占2.0%,增生型4只眼占0.7%;②视力预后与分型有密切关系。以视力大于或等于0.5计,无渗漏型占99.4%,局部水肿型占83.0%,弥漫水肿型占28.4%,缺血型占8.4%,增生型无1只眼在0.5以上。黄斑囊样水肿占20.3%。③分期与视力预后,随期数愈高视力预后愈差,视力大于或等于0.5者,1期占96.2%,2期占84.8%,3期占53.2%,4期占37.2%,5期占12.5%。 结论 糖尿病黄斑病变是导致糖尿病患者视力减退的重要因素,不同分型有不同的预后.黄斑水肿和囊样水肿应作激光治疗以阻止视力下降。 (中华眼底病杂志,2000,16:144-146)     

Optical coherence tomographic assessment of diabetic macular edema: comparison with fluorescein angiographic and clinical findings

PURPOSE: To compare the optical coherence tomographic (OCT) features with clinical and fluorescein angiographic (FA) findings in patients with diabetic retinopathy. METHODS: In a retrospective study ophthalmologic examination together with FA and OCT images were obtained from 195 eyes of 110 patients with different stages of diabetic retinopathy and OCT images were obtained from 40 eyes of 20 control subjects. Fluorescein leakage characteristics were organized into five groups: no leakage (1), focal (2), diffuse (3), combined focal+diffuse leakage (4) and cystoid (5). The Pearson correlation test was used to test the correlation between visual acuity and central foveal thickness and ANOVA was used for the statistical comparison between the groups. RESULTS: The OCT images demonstrated retinal swelling in 66.1% of eyes, cystoid macular edema (CME) in 11.8% of eyes, serous foveal detachment + swelling in 6.2% of eyes, serous foveal detachment+swelling+CME in 3.6% of eyes and normal foveal structure in 12.3% of eyes. The best-corrected visual acuity was significantly correlated with central foveal thickness (r:-0.528, p<0.01). There was 77% agreement between clinical examination and OCT results. CME was detected with OCT in 15.4% of eyes in our study, 40% of which was not detected with slit-lamp biomicroscopy and 63.3% of which was not evident in FA. None of the serous foveal detachments could be detected during slit-lamp biomicroscopy or FA. CONCLUSIONS: OCT-3 provided objective documentation of foveal structural changes in eyes with diabetic retinopathy. Best-corrected visual acuity provided a significant correlation with the retinal thickness at the central fovea. These results indicate that OCT can facilitate deciding on the treatment protocol (surgical or medical) and follow-up of diabetic patients, which is especially important in the early stages of diabetic maculopathy when the structural changes are not yet evident with slit-lamp biomicroscopy or angiographically.     

Tractional cystoid macular edema: a subtle variant of the vitreomacular traction syndrome

PURPOSE: To describe clinical characteristics and treatment outcomes in a series of patients with tractional cystoid macular edema, a subtle variant of the vitreomacular traction syndrome. DESIGN: Retrospective, uncontrolled, observational, and interventional case series. METHODS: Patient population: Ten consecutive patients (11 eyes) with multicystoid foveolar thickening caused by localized perifoveal vitreous detachment. EXPERIMENTAL PROCEDURES: Slit-lamp biomicroscopy and fluorescein angiography; confirmation of vitreomacular relationship with B-scan ultrasonography, optical coherence tomography (OCT), or both. Vitrectomy with peeling of posterior hyaloid in 8 eyes with pretreatment visual acuity 相似文献   

糖尿病黄斑水肿的临床诊断方法比较

目的 对比分析糖尿病黄斑水肿患者光学相干断层扫描(optical coherence tomo-graphy,OCT)、荧光素眼底血管造影(fluorescein fundus angiography,FFA)及裂隙灯显微镜下+90 D前置镜检查所观察到的图像特征,探讨3种检查方法的诊断价值.方法 分析51例(94眼)临床确诊为糖尿病视网膜病变患者的OCT、FFA及裂隙灯显微镜下+90 D前置镜检查结果,将结果进行一致性比较,并观察分析OCT、FFA图像特征,所得结果行单因紊方差分析.结果 OCT与FFA及FFA与+90 D前置镜检查结果有较好的一致性,符合率分别为88.3%、69.1%.OCT、FFA与+90 D前置镜裂隙灯显微镜下检查结果对糖尿病黄斑水肿的检出率分别是86.2%、83.0%及62.8%.OCT所测得的黄斑中心凹平均视网膜厚度值在无渗漏时最低,并随局限性渗漏、弥漫性渗漏、局限合并弥漫性渗漏、黄斑囊样水肿依次增加,经比较它们之间的差异均具有统计学意义(F=40,P均<0.05).结论 OCT能客观的提供糖尿病患者黄斑区结构的变化,尤其对+90D前置镜裂隙灯显微镜下检查及FFA还没有明确变化的早期黄斑水肿诊断敏感.三者的联合应用为揭示糖尿病病理机制、临床诊断糖尿病黄斑水肿、判断糖尿病黄斑水肿的类型及其最佳治疗方案提供参考依据.     

糖尿病视网膜病变患者黄斑病变的 光学相干断层扫描

目的观察糖尿病视网膜病变患者黄斑病变的光学相干断层扫描(optical coherence tomography,OCT)图像特征。方法对60例糖尿病黄斑病变患者以及30例正常对照者进行OCT检查。其中54例糖尿病黄斑病变患者同时行荧光素眼底血管造影(fundus fluorescein angiography,FFA)检查,对两种检查方法的结果进行比较。结果OCT检查糖尿病黄 斑病变患者中心凹平均厚度为(314.54±154.13)μm。视网膜水肿者占57.1%,视网膜水肿合并黄斑囊样水肿(cystoid macular edema,CME）者占38.5%,合并神经上皮脱离者 占9.2%,合并CME及神经上皮脱离者占16.9%。OCT检查黄斑正常厚度及轻度水肿者,FFA主要呈限局性渗漏;中重度水肿者,FFA呈弥漫性渗漏。CME检出率FFA检查者为28.6%,OCT检 查者为58.9%,二者比较差异有显著性意义(t=3.39,P<0.05) 。结论糖尿病黄斑病变者的OCT图像有视网膜水肿、CME及神经上皮脱离3种形态特征。OCT在检测发现CME等方面优于FFA。(中华眼底病杂志,2001,17:184-186)     

Morphological and functional analyses of diabetic macular edema by optical coherence tomography and multifocal electroretinograms

PURPOSE: To determine the correlation between the tomographic features and the visual functions of eyes with diabetic macular edema. METHODS: Optical coherence tomographic (OCT) images and multifocal electroretinograms were obtained from 45 eyes of 25 patients with diabetic macular edema and from 21 eyes of 21 normal subjects. RESULTS: The OCT images showed cystoid macular edema in 18 eyes and diffuse retinal swelling without cystoid edema in the other 27 eyes. The fovea was significantly thicker in eyes with cystoid macular edema and in those with diffuse retinal swelling than in normal eyes. The fovea of eyes with cystoid edema was significantly thicker than the fovea of eyes with diffuse swelling. The best-corrected visual acuity and the electrical response density from the macular area were significantly reduced in eyes with diabetic macular edema, particularly in those with cystoid edema. The best-corrected visual acuity and macular response density of the multifocal ERGs were inversely correlated, and the implicit times were directly correlated with foveal thickness. CONCLUSION: The visual acuity was correlated significantly with morphological changes revealed by OCT and with multifocal ERGs. The combination of OCT and multifocal ERGs may provide objective criteria for the evaluation and assessment of diabetic macular edema.     

Ischemic maculopathy following intravitreal bevacizumab for refractory diabetic macular edema

A 58-year-old male presented with decreased visual acuity from persistent diffuse diabetic macular edema despite multiple interventions including laser photocoagulation and intravitreal triamcinolone acetonide injections. Following treatment with 1.25 mg of intravitreal bevacizumab, reduction in macular leakage was shown by fluorescein angiography and resolution of edema was shown by optical coherence tomography (OCT); however, visual acuity deteriorated and fluorescein angiograms demonstrated progressive enlargement of the foveal avascular zone (FAZ), which had shown no abnormalities before the injection. Despite normalisation of macular thickness on OCT and cessation of leakage on angiography, visual acuity remained at the same level until 6 months of follow-up. Intravitreal bevacizumab must be used with caution in patients with chronic, persistent diabetic macular edema. Disruption of the fragile fine foveal network of capillaries with induction of macular ischemia may result following treatment even if there are no pre-existing defects in the FAZ and may be responsible for non-improvement or decrease in visual acuity.     

糖尿病黄斑水肿相关因素分析

目的:探讨糖尿病黄斑水肿(diabetic macular edema,DME)与糖尿病病程和视力之间的关系。方法: 回顾性分析40例40眼荧光素眼底血管造影(fluorescence fundus angiography,FFA)及光学相干断层扫描(optical coherence tomography,OCT)确诊的DME患者的检查结果、糖尿病病程和视力等临床资料。分析各种类型DME与以上相关因素的关系。结果: DME患者40例40眼中,局限型DME14眼(35%),弥漫型20眼(50%),囊样水肿6眼(15%)。患者的视力与DME的类型具有显著相关性(r=-0.835,P=0.000),黄斑囊样水肿较局限型水肿对视力的损害更严重。糖尿病病程与DME的类型具有显著相关性(r=0.472,P=0.002)。结论: DME与糖尿病病程、视力均存在显著相关性。     

Optical coherence tomography of idiopathic juxtafoveolar telangiectasia.

BACKGROUND AND OBJECTIVE: To document optical coherence tomography (OCT) findings in a series of eyes with group 2A idiopathic juxtafoveal telangiectasia. PATIENTS AND METHODS: This study is a retrospective review of patient charts, OCT, fundus photography, and fluorescein angiography involving 23 eyes (12 patients). Mean retinal thickness in 9 macular areas was calculated and compared to previously published measurements from normal eyes. RESULTS: OCT in 8 of 13 stage 3 eyes revealed foveal cysts without evidence of cystoid macular edema on fluorescein angiography or biomicroscopy, and 1 lamellar hole. In stage 3 eyes, mild retinal thickening was found in 7 of 9 macular areas (P < .05). CONCLUSIONS: OCT commonly reveals foveal cysts in stage 3 idiopathic juxtafoveal telangiectasia. Consistent findings of associated mild macular thickening and lack of late petaloid hyperfluorescence on fluorescein angiography suggest that these cysts differ in pathophysiology from cystoid macular     

Cystoid macular degeneration in chronic central serous chorioretinopathy

PURPOSE: To describe the optical coherence tomography (OCT) and fluorescein angiography findings in the macula of eyes with chronic central serous chorioretinopathy (CSC) and reduced central vision. METHODS: Using OCT, clinical examination, and fluorescein and indocyanine green (ICG) angiography, the authors examined eight eyes of seven patients with CSC, an attached macula, and reduced central vision of 20/200 or worse. All had a history of chronic CSC with resolution of the subretinal fluid in the macular area and poor vision. RESULTS: Patient ages ranged from 55 to 82 years (mean, 66 years). All eight eyes had some parafoveal, patchy RPE atrophy with corresponding transmission hyperfluorescence (window defect) on fluorescein angiography. Five eyes also had a window defect in the foveal area. With OCT, the foveal area revealed variable areas of cystoid change and atrophy in seven of the eight eyes. In four of these eyes, the cystoid changes were not seen on clinical examination or fluorescein angiography. The seven eyes with cystoid changes imaged with OCT had no intraretinal leakage of fluorescein in the foveal region. The authors categorized these eyes as having cystoid macular degeneration (CMD). One other eye had foveal thinning or atrophy without cystoid changes. CONCLUSIONS: Intraretinal cystoid spaces without intraretinal leakage, or CMD, was a common finding in eyes with chronic CSC and reduced central vision after resolution of subretinal fluid. OCT was useful to establish the presence of CMD and foveal atrophy, even when these changes were not clearly evident on clinical examination or fluorescein angiography. Chronic foveal detachment and antecedent intraretinal leakage were proposed to be the mechanisms for the development of the changes. CMD in conjunction with foveal atrophy was an important clinical finding to account for the poor visual outcome in patients with CSC.     

Optical coherence tomography in the diagnosis and monitoring of cystoid macular edema in patients with retinitis pigmentosa

PURPOSE: To identify cystoid macular edema (CME) in patients with retinitis pigmentosa (RP) using optical coherence tomography (OCT) and to evaluate response to acetazolamide by serial OCT. METHODS: Twenty-nine consecutive RP patients were included in the study. Patients with CME were treated with acetazolamide (125 or 250 mg/d for 4-12 months). OCT, fluorescein angiography, and determination of best-corrected visual acuity (BCVA) were performed initially and throughout the follow-up period. RESULTS: Ten of the 29 patients had CME by OCT. Of these 10 patients, 5 had various degrees of fluorescein leakage by fluorescein angiography. After acetazolamide treatment, six patients had significant decreases in macular edema in at least one eye by follow-up OCT. In six patients, visual acuity improved by > or =1 line in at least one eye. The change of central foveal thickness shown by OCT was significantly correlated with the change of logMAR of BCVA (Pearson correlation coefficient [r] = 0.576; P = 0.008). We observed no differences in the change of central foveal thickness by OCT (Mann-Whitney test; P = 1.000) and in the change of logMAR of BCVA (Mann-Whitney test; P = 0.106) between patients treated with 125 mg/d acetazolamide and those treated with 250 mg/d acetazolamide. CONCLUSIONS: These results indicate that OCT is a valuable tool in the detection and follow-up of CME in RP patients. Treatment with acetazolamide resulted in marked improvement in OCT-diagnosed CME in RP, but visual improvement was variable.     

Fundus microperimetry patterns of fixation in type 2 diabetic patients with diffuse macular edema

BACKGROUND: Recently developed fundus microperimetry (MP-1; Nidek Technologies, Srl. Vigonza PD, Italy) was used to evaluate fixation patterns and retinal sensitivity in patients who had clinically significant macular edema with a diffuse pattern and type 2 diabetes mellitus. METHODS: In a prospective, observational case series study, 84 consecutive patients with type 2 diabetes (84 eyes) who had clinically significant macular edema with a diffuse pattern were studied by means of MP-1. Main outcome measures were fixation stability and position and mean retinal sensitivities within the central 2 degrees and 8 degrees areas. Logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) was evaluated by means of an Early Treatment of Diabetic Retinopathy Study chart. Foveal thickness was measured by Stratus optical coherence tomography (OCT; Carl Zeiss Meditec, Inc., Dublin, CA). Age, duration of diabetes, hemoglobin A1c (HbA1c) levels, duration of symptoms, history of panretinal photocoagulation, vitreomacular adhesion, and cystoid macular changes were documented. Patients were grouped according to both position of fixation (central or eccentric) and stability of fixation (stable or unstable). Statistical analyses included independent samples t-test, binomial test, Bonferroni correction for multiple comparisons, and generalized linear model univariate analysis. RESULTS: Of 84 eyes, 44 (52.4%) had central fixation, and 40 (47.6%) had eccentric fixation. Of 84 eyes, 34 (40.5%) had stable fixation, and 50 (59.5%) had unstable fixation. In the whole sample, mean central 2 degrees retinal sensitivity +/- SD was 6.26 +/- 3.19 dB (range, 0-14.80 dB), and mean central 8 degrees retinal sensitivity +/- SD was 7.62 +/- 2.55 (range, 3.85-14.90 dB); logMAR BCVA ranged from 0.1 to 1.3 (mean +/- SD, 0.6 +/- 0.29). Mean OCT foveal thickness +/- SD was 300.77 +/- 66.93 m (range, 220-525 m). Both comparisons between groups (stable vs. unstable and central vs. eccentric) showed statistically significant differences in mean logMAR BCVA, mean central 2 degrees and 8 degrees retinal sensitivities, and mean OCT foveal thickness. Duration of symptoms was significantly longer and HbA1c levels were higher in the groups with deterioration of stability or centrality of fixation. The prevalence of cystoid macular changes was significantly higher in the groups with eccentric or unstable fixation (P < 0.001). Generalized linear model statistical analysis showed that logMAR BCVA was significantly associated with stability of fixation (P = 0.020), mean central 8 degrees retinal sensitivity (P < 0.001), and mean OCT foveal thickness (P < 0.001). The interaction between stability of fixation and mean OCT foveal thickness showed a statistically significant association with logMAR BCVA (P = 0.003). Some eyes with eccentric fixation presented with stable fixation, especially in the presence of long-lasting symptoms, and had better visual acuity than eyes with central, but unstable fixation. CONCLUSION: Visual acuity, central retinal sensitivity, foveal thickness, duration of symptoms, HbA1c levels, and presence of cystoid macular changes were strongly associated with fixation impairment in type 2 diabetic patients who had clinically significant macular edema with a diffuse pattern. Stability of fixation and foveal thickness play a major role in conditioning BCVA.     

Optical coherence tomography findings in diabetic macular edema before and after vitrectomy

BACKGROUND AND OBJECTIVE: To assess the role of optical coherence tomography (OCT) in the evaluation and follow-up after vitrectomy for diabetic macular edema. MATERIALS AND METHODS: The 18 eyes of 12 patients affected by presumed diabetic vitreous-induced macular edema underwent biomicroscopy with a Goldmann contact lens, fluorescein angiography, and OCT. RESULTS: OCT revealed two patterns of edema. The first group (15 eyes) was characterized by widespread thickening of the neurosensory retina with an increased nonhomogeneous reflectivity of the inner retinal layers; cystoid-like spaces of absent or reduced reflectivity in the neurosensory retina were also present. In the second group (3 eyes), a cystoid macular edema with a dome-shaped foveal profile because of a markedly increased retinal thickness in the foveal region was observed. The disappearance of the physiologic foveal profile was always seen. Biomicroscopy revealed an increased reflex of the inner limiting membrane in the first group and minimal alterations in the second one. Four patients (7 eyes) underwent vitrectomy with posterior hyaloid removal. In 5 eyes, the patients experienced a visual improvement greater than two Snellen lines. The restoration of the normal foveal profile and the reduction of the retinal thickness on the OCT were evident in all cases one month after surgery. CONCLUSION: OCT appears to be a useful tool in the diagnosis and management of diabetic macular edema and in the monitoring of the morphological changes after vitrectomy.     

不同类型糖尿病性黄斑水肿的多焦视网膜电图分析

背景了解糖尿病患者的视网膜功能变化对于指导临床治疗非常重要。目前对糖尿病性黄斑水肿（DME）患者的研究包括荧光素眼底血管造影（FFA）、多焦视网膜电图（mfERG）等,但对不同类型DME患者mfERG特征的研究较少。目的探讨不同类型DME患者的mfERG改变。方法病例对照研究。对确诊糖尿病视网膜病变（DR）合并临床显著黄斑水肿的40例57眼进行mfERG和FFA检查,同时对年龄和性别相匹配的正常对照组35例35眼行mfERG检查,并进行比较。依照FFA表现将DME分为局限型DME13例16眼、弥漫型DME17例22眼和囊样型DME12例17眼,分析各类型DME患者mfERG的特征。结果与正常对照组比较,局限型DME组患者mfERG1环的P．波反应密度显著下降,P。波4环、5环隐含时明显延迟,差异均有统计学意义（t=2．170,P=0．038;t=2．519,P=0．017;t=2．451,P=0．020）;4环N1波隐含时明显延迟,差异有统计学意义（t=2．858,P=0．008）。弥漫型DME组患者1、3、5环P。波反应密度显著下降,1、3、4、5环N1波反应密度显著下降,差异均有统计学意义（P〈0．05）;3环、4环P,波隐含时明显延迟,差异均有统计学意义（t=2．446,P=0．019;t=2．759,P=0．009）。与正常对照组比较,囊样型DME组患者1～5环P,波反应密度显著下降,1、3、4、5环N．波反应密度显著下降,差异均有统计学意义（P〈0．05）;3、4、5环P。波隐含时明显延迟,4环N,波隐含时明显延迟,差异均有统计学意义（P〈0．05）。黄斑区功能在中心凹处严重受损,外环功能虽有不同程度下降,但均较中心凹功能下降程度轻。结论不同类型DME的局部视网膜功能改变程度与FFA的形态学表现结果一致,各型DME患者中黄斑中心凹功能受累程度由重至轻依次为囊样型DME、弥漫型DME及局限型DME。FFA与mfERG联合诊断可以全面、多角度地反映糖尿病患者黄斑区功能的变化情况。     

Quantitative assessment of retinal thickness in diabetic patients with and without clinically significant macular edema using optical coherence tomography

PURPOSE: To assess patients with diabetic macular edema quantitatively using optical coherence tomography (OCT). METHODS: OCT was performed in 14 eyes with diabetic retinopathy and ophthalmoscopic evidence of clinically significant macular edema (CSME) and in 19 diabetic eyes without CSME. Retinal thickness was computed from the tomograms at fovea and other 36 locations throughout the macula. RESULTS: The mean +/- standard deviation foveal thickness was 255.6 +/- 138.9 microm in eyes with CSME, and 174.6 +/- 38.2 microm in eyes without CSME (p = 0.051). Within 2000 microm of the center of the macula, eyes with CSME had significantly thicker retina in the inferior quadrant than those without CSME (p < 0.01). The foveal thickness was correlated with logMAR visual acuity (gamma = 0.68, p < 0.01). OCT identified sponge-like retinal swelling and/or cystoid macular edema in 11 (58%) eyes without CSME, and in 12 (86%) eyes with CSME. CONCLUSIONS: Criteria of CSME seem to be insufficient in really identifying macular edema. OCT may be more sensitive than a clinical examination in assessing diabetic macular edema and is a quantitative tool for documenting changes in macular thickening.     

Serial optical coherence tomography of subthreshold diode laser micropulse photocoagulation for diabetic macular edema.

BACKGROUND AND OBJECTIVE: To use serial optical coherence tomography (OCT) to evaluate low-intensity, high-density subthreshold diode laser micropulse photocoagulation treatment of clinically significant diabetic macular edema. PATIENTS AND METHODS: Eighteen consecutive eyes of 14 patients with clinically significant diabetic macular edema and a minimum foveal thickness of 223 microm or greater were prospectively evaluated by OCT preoperatively and 1, 4, and 12 weeks following treatment. RESULTS: Overall, estimated macular edema 3 months postoperatively (minimum foveal thickness--223 microm) was reduced a mean of 24% (P = .02). Eleven eyes treated for recurrent or persistent clinically significant diabetic macular edema following prior treatment more than 3 months before study entry were most improved, with a mean reduction in estimated macular edema 3 months postoperatively of 59%. No treatment complications were observed. No patient demonstrated laser lesions following treatment. CONCLUSIONS: Low-intensity, high-density subthreshold diode laser micropulse photocoagulation can reduce or eliminate clinically significant diabetic macular edema measured by OCT. Further study is warranted.     

糖尿病性黄斑水肿的光学相干断层扫描与荧光血管造影图像的对比分析

目的对比分析糖尿病视网膜病变患者的光学相干断层扫描(optical coherence tomography,OCT)与荧光血管造影(fluorescein angiographic,FA)图像。方法回顾性分析不同阶段糖尿病视网膜病变70例患者95眼的OCT和FA图像。结果OCT图像显示视网膜水肿占70.5%,囊样黄斑水肿(cystoid macular edema,CME)占13.7%,浆液性黄斑脱离并发水肿占4.2%,浆液性黄斑脱离并发水肿和CME占2.1%,正常黄斑结构占9.5%。结论OCT为糖尿病视网膜病变黄斑结构的变化提供了依据,特别是对FA未能发现的早期黄斑结构改变的诊断具有重要意义。     

糖尿病性黄斑水肿的FFA与OCT的应用对比

目的:探讨糖尿病性黄斑水肿FFA与OCT的应用及其相互关系。方法:对70例135眼糖尿病性黄斑水肿患者行中心视力、最佳矫正视力、眼压、直接检眼镜、裂隙灯显微镜联合+90D前置镜散瞳眼底检查、散瞳眼底彩色照相、相干光断层扫描(OCT)、荧光素眼底血管造影(FFA)检查,并将相干光断层扫描和荧光素眼底血管造影结果比较分析。结果:轻度水肿时,FFA表现异常56眼,OCT表现异常68眼(P=0.0009);FFA表现正常12眼中,其OCT检查有10眼为海绵样改变;FFA表现为囊样型的,其OCT表现为囊样型占46.7%。结论:FFA,OCT联合应用于诊断糖尿病性黄斑水肿,而OCT作为临床随访DME是必不可少的检查手段,早期应用有优势。