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1.
目的 研究光学相干断层扫描(opticalcoherencetomography,OCT)在视网膜中央动脉阻塞(centralretinalarteryocclu-sion,CRAO)上的诊断价值。方法 应用眼底荧光血管造影(fundusfluoresceinangiography,FFA)将黄斑水肿患者分成病例组(CRAO患者)、对照组[即视网膜中央静脉阻塞(centralretinalveinocclusion,CRVO)患者及糖尿病性黄斑水肿(diabeticmaculare-dema,DME)患者]。测量黄斑中心小凹从内界膜到色素上皮层之间的厚度(黄斑中心小凹厚度);通过黄斑中心小凹中点向色素上皮层作垂线,连接黄斑中心小凹中点与鼻侧距中心小凹200μm处作一直线,测量垂线与上述直线所形成的夹角(简称角度)。对数据进行统计学分析。结果 黄斑区水肿在OCT扫描中的主要表现为:黄斑区囊样水肿,视网膜神经上皮下积液,视网膜内层细胞内水肿。病例组和对照组的黄斑中心小凹厚度及角度差异均有统计学意义(均为P<0.05);将测得的黄斑中心小凹厚度绘制ROC曲线,曲线下面积为0.912,最佳临界值为205.00μm,该点灵敏度0.90,特异度0.87,Youden指数0.77;将测得的角度绘制ROC曲线,曲线下面积为0.966,最佳临界值为72.00°,该点灵敏度0.97,特异度0.90,Youden指数0.87。结论 两种诊断方法都说明OCT对CRAO有较好的诊断价值,但测量角度灵敏度和特异度都较测量黄斑中心小凹高,说明有更高的准确率。  相似文献   

2.
黎铧  李娟娟 《眼科新进展》2016,(12):1141-1144
目的 采用频域光学相干断层扫描技术(specialdomainopticalcoherencetomo-graphy,SD-OCT)对先天性视盘小凹合并黄斑病变的发病机制进行探讨。方法 回顾分析我院眼科2013年1月至2016年1月所诊治的先天性视盘小凹患者18例(18眼),对其SD-OCT结果进行分析总结。结果 18例患者中SD-OCT视盘处扫描均可见视盘小凹玻璃体条索牵拉,玻璃体牵拉可位于小凹的边缘或小凹的内部;视网膜神经上皮层脱离腔或劈裂腔存在与小凹相通的间隙和空间,这一间隙延伸至筛板以下区域,所有患者筛板结构不完整。同时所有患者均未见视网膜神经上皮层脱离腔或劈裂腔存在与玻璃体相通的间隙和空间。结论 先天性视盘小凹并不是单一发病因素所引发,而是由于先天解剖异常加上玻璃体交界面上病理生理改变所导致。  相似文献   

3.
应用光学相干断层成像术测量正常人视网膜神经纤维层厚度   总被引:28,自引:0,他引:28  
Liu X  Ling Y  Luo R  Ge J  Zhou W  Zheng X 《中华眼科杂志》2000,36(5):362-365,I020
目的 评价光学相干断层成像术(optical coherence tomogrdphy,OCT)在正常人视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度测量中的星夜价值及其测量重复性,探讨正常人各年龄组之间RNFL厚度是否存在差异。方法 用OCT对152例(152只眼)正常人进行以视乳头中点为中尽,直径为3.46mm圆周的RNFL厚度测量,将检查者按10岁为一个  相似文献   

4.
应用光学相干断层成像术测量正常人黄斑厚度的研究   总被引:4,自引:0,他引:4  
仲路  周欣 《国际眼科杂志》2009,9(6):1165-1166
目的:应用光学相干断层成像术(optical coherence tomography,OCT)测量我国正常人黄斑中央小凹厚度,黄斑中心凹体积。方法:用OCT对50例100眼正常人(18~40岁)进行经黄斑中央小凹快速黄斑厚度扫描,扫描深度2mm,采用OCT3000视网膜厚度容量列表分析软件计算黄斑中央小凹厚度、黄斑中心凹体积的均数和标准差。对正常人双眼黄斑中央小凹厚度的均数和标准差进行比较;对正常人双眼黄斑中央小凹体积的均数和标准差进行比较;随机取右眼数值做正常对照组,根据公式x-±1.96s计算出正常人黄斑中央小凹厚度,黄斑中心凹体积的正常参考值。结果:正常人中心小凹厚度为114.54~166.74μm,双眼之间比较差异无统计学意义(P=0.401);正常人黄斑中心凹体积为0.114~0.162mm3,双眼之间比较差异无统计学意义(P=0.153)。结论:OCT能精确测量正常人黄斑视网膜厚度,可为临床黄斑疾病的诊治提供客观、定量的指标。  相似文献   

5.
目的 探讨原发性开角型青光眼(primary open angle glaucoma,POAG)的光学相干断层成像术(optical coherence tomography,OCT)的图像特征,POAG患者视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度与正常人之间的差异,RNFL与视野指数之间的关系。方法 采用OCT对83例(149只眼)POAG患者和83例  相似文献   

6.
张敏  朱健华  冯浩  刘静 《眼科新进展》2016,(11):1061-1064
目的 观察视网膜静脉阻塞合并黄斑水肿患者黄斑区微结构的光学相干断层扫描(opticalcoherencetomography,OCT)特征,探讨黄斑区微结构的改变与视力的关系。方法 采用OCT对46例(46眼)视网膜静脉阻塞合并黄斑水肿患者进行黄斑区微结构检查,分析黄斑水肿形态,对不同形态黄斑水肿的患者进行比较,以患眼作为黄斑水肿组,对侧眼作为对照组,分析黄斑区微结构各参数与视力的相关性。结果 OCT扫描结果显示46眼视网膜静脉阻塞合并黄斑水肿的患者黄斑区微结构表现为3种形态,12眼为黄斑囊样水肿,10眼为浆液性神经上皮层脱离,24眼为混合型水肿即黄斑囊样水肿伴浆液性神经上皮层脱离。对照组黄斑中心凹视网膜厚度、黄斑中心凹1mm环平均视网膜厚度及平均视网膜容积分别为(180.81±13.35)μm、(238.72±16.75)μm及(0.17±0.03)mm3,而黄斑水肿组分别为(541.26±125.68)μm、(473.61±133.42)μm及(0.38±0.14)mm3,两组比较差异均有统计学意义(均为P=0.000)。根据患者黄斑区微结构形态表现分组研究发现,浆液性神经上皮层脱离患者BCVA最好,为(0.53±0.09)LogMAR,其次为黄斑囊样水肿患者(0.64±0.16)LogMAR,而混合型患者最差(1.02±0.24)LogMAR,3组之间差异有统计学意义(P=0.008)。浆液性神经上皮层脱离患者中心凹视网膜厚度、黄斑中心凹1mm环平均视网膜厚度及平均视网膜容积最小,其次为黄斑囊样水肿患者,而混合型患者3个指标均最大,3组之间差异均有统计学意义(均为P=0.000)。对黄斑部微结构的改变与BCVA进行相关性分析发现:黄斑中心凹视网膜厚度、黄斑中心凹1mm环平均视网膜厚度、黄斑中心凹1mm环平均视网膜容积、IS/OS断裂长度及外界膜断裂长度与BCVA(LogMAR)均呈正相关(r=0.546,P=0.000;r=0.582,P=0.000;r=0.523,P=0.000;r=0.834,P=0.000;r=0.758,P=0.000)。黄斑水肿形态与BCVA呈正相关(r=0.641,P=0.000),单纯的浆液性神经上皮层脱离患者BCVA最好,混合型的患者病变最重,BCVA也最差。结论 视网膜静脉阻塞所致的黄斑水肿表现形态不同,OCT可以对黄斑部微结构改变进行定量分析,黄斑区形态改变与视力密切相关。  相似文献   

7.
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   

8.
黄斑裂孔的光学相干断层成像分析   总被引:27,自引:0,他引:27  
Wei W  Yang W  Zhao L  Shi X  Chen Z  Wang J 《中华眼科杂志》1999,35(6):419-421
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  相似文献   

9.
目的 通过眼底荧光血管造影(fudusfluoresceinangiography,FFA)和光学相干断层扫描(opticalcoherencetomopraphy,OCT)探讨高度近视黄斑区脉络膜新生血管(choroidalneovascularization,CNV)的特征。方法 对45例(45眼)高度近视患者黄斑区CNV进行FFA及OCT检查,并对两种不同的图像检查结果进行对比分析。结果 CNV位于中心凹者27眼,最佳矫正视力平均为0.08;CNV位于中心凹以外(未累及中心凹)者18眼,最佳矫正视力平均为0.32,二者相比差异有统计学意义。CNV位置与患者的年龄和眼轴长度无关。FFA显示典型CNV29眼,CNV边界清晰且具有一定的形态,随脉络膜背景荧光逐渐增强而增强,晚期呈边界清晰的片状高荧光;隐匿型CNV16眼,FFA显示CNV呈现边界欠清的强荧光。OCT显示典型CNV31眼,CNV自视网膜色素上皮层向上隆起,呈边界清晰的纺锤形或类圆形强反射;隐匿型CNV14眼,多位于视网膜色素上皮层平面,表现为不规则增强紊乱的反射信号。结论 高度近视黄斑区CNV的FFA和OCT形态学特征密切相关,结合FFA和OCT的图像特征对高度近视黄斑区CNV形态学改变进行对比分析,有助于明确病变的性质,为临床诊疗提供帮助。  相似文献   

10.
目的 应用光学相干断层扫描(opticalcoherencetomography,OCT)测量早产儿视盘周围视网膜神经纤维层(retinalnervefiberlayer,RNFL)、黄斑中心凹处视网膜及黄斑中心凹下脉络膜的厚度,了解早产儿视网膜及脉络膜的结构特点。方法 2006年9月至2008年9月在南方医科大学珠江医院出生的31例(62眼)无早产儿视网膜病变(retinopa-thyofprematurity,ROP)的早产儿为早产儿组,同期出生的35例(70眼)足月儿为足月儿组。应用频域OCT行视盘环形扫描,测量不同象限和不同钟点范围的RNFL厚度并计算全周平均RNFL厚度;应用传统扫描方式和深度扫描图像增强技术对被检者眼黄斑中心凹水平和垂直方位进行扫描,测量黄斑中心凹处视网膜及中心凹下脉络膜厚度。结果 早产儿各象限及全周平均RNFL厚度均较足月儿薄,其中下方、鼻侧及全周平均RNFL厚度与对照组比较差异均有统计学意义(均为P<0.01)。早产儿黄斑中心凹处视网膜厚度比足月儿厚,差异有统计学意义(P<0.001)。早产儿黄斑中心凹下脉络膜厚度与足月儿相比差异无统计学意义(P>0.05)。结论 早产儿RNFL厚度较足月儿薄,黄斑中心凹处视网膜厚度比足月儿厚,黄斑中心凹下脉络膜厚度无明显差异。  相似文献   

11.
Retinal thickness and changes with age   总被引:5,自引:0,他引:5  
PURPOSE: We studied the morphological changes occurring with aging in the macula using optical coherence tomography(OCT). METHODS: Forty-seven eyes from 47 normal volunteers were studied. The subjects ranged in age from 21 to 79 years and their refractive errors were within +/- 3.00 diopters. The measurement of the retinal thickness was done by OCT. The retinal thickness was evaluated at five points: the foveola, and 1 mm superior, inferior, nasal, and temporal to the foveola. The axial length of the eye and the refraction were also measured in all subjects. RESULTS: The retinal thickness was 142 +/- 15 microns at the foveola, 257 +/- 18 microns at the superior point, 255 +/- 18 microns at the inferior point, 246 +/- 20 microns at the temporal point, and 261 +/- 21 microns at the nasal point (mean +/- standard deviation). All points except the foveola showed reduced retinal thickness with age. Thus, attenuation of the retinal thickness in the parafoveal area was correlated significantly with age. However, no change in the retinal thickness at the foveola was observed with increasing age. Neither axial length nor refractive error biased this result. CONCLUSION: Our results demonstrated that the macular thickness changes with aging, but no obvious change could be detected in the foveola.  相似文献   

12.
单眼弱视患者黄斑光学相干断层成像检查   总被引:1,自引:0,他引:1  
目的探索弱视黄斑部视网膜发育状况。方法使用光学相干断层成像技术(OCT)观察一组39例单眼弱视患者眼底黄斑区的组织形态,测定中心小凹及黄斑区周围3mm直径范围视网膜神经上皮层平均厚度,并进行相关分析。结果中心凹视网膜神经上皮厚度正常眼与弱视眼比较差异有非常显著性,弱视眼黄斑区上方、鼻侧、下方视网膜神经上皮层明显增厚,与颞侧比较差异有显著性。2例弱视患者弱视眼黄斑中心凹未形成,其中1例治疗效果不佳。结论OCT检查可以从组织形态上观察黄斑发育情况。  相似文献   

13.
目的测量正常人黄斑部各分区的视网膜神经上皮层厚度(neurosensory retinal thickness,NRT)。方法应用光学相干断层成像术(optical coherence tomography,OCT3000)对60例(120眼)正常人的黄斑部进行扫描,扫描模式为快速黄斑厚度地形图(fast macular thickness map),分析模式为视网膜厚度/体积分析(retinal thickness/volume analysis),应用OCT3000自带软件分别测出9个分区和黄斑中心小凹的NRT及总黄斑体积。用SPSS11.0统计软件包分析不同年龄、眼别、性别组间上述指标有无统计学差异。结果不同年龄组间除黄斑中心小凹、上、下方外环区、总黄斑体积外(P<0.05),其余部位差异均无显著性;不同眼别间除鼻侧内环区、上、下方外环区、颞侧外环区外(P<0.05),其余部位差异均无显著性;不同性别间中央区、内环区各象限、鼻侧外环区、颞侧外环区、总黄斑体积差异有显著性(P<0.05)。结论OCT3000可用于测量黄斑部各分区的NRT,其厚度值存在年龄、眼别及性别差异。  相似文献   

14.
目的观察渗出型老年性黄斑变性(exudative age-related macular degeneration, AMD)和中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy, CEC)脉络膜新生血管 (choroidal neovascularization, CNV) 的光学相干断层扫描 (optical coherence tomography, OCT) 图像特征并比较两者之间的差异。方法对渗出型AMD 患者22例23只眼,CEC患者19例20只眼进行OCT检测,应用OCT软件进行CNV大小及黄斑中心凹视网膜神经上皮层厚度测量并分析两者与视力的关系。结果CNV的OCT 图像主要表现有:单纯性CNV、CNV伴浆液性神经上皮层脱离和CNV伴脉络膜视网膜渗出(可伴有浆液性神经上皮层脱离及浆液性或出血性色素上皮脱离)。渗出型AMD的CNV以CNV伴脉络膜视网膜渗出为主,有13只眼,占56.52%,其CNV累及范围较大;CEC的CNV以单纯性CNV为主,有18只眼,占90.00 %,其CNV累及范围相对较小。两组患者视力与黄斑中心凹视网膜神经上皮层厚度呈负相关( γ=-0.521,P=0.001)。结论渗出型AMD与CEC其CNV具有不同的OCT 形态特征,CNV累及范围也有差异。(中华眼底病杂志,2001,17:299-302)  相似文献   

15.
PURPOSE: To examine the thickness and structural features of the ophthalmoscopically normal-appearing, attached retina in rhegmatogenous retinal detachments by optical coherence tomography (OCT) and compare them with those of the fellow eye. METHODS: Seventy eyes of 35 patients with rhegmatogenous retinal detachments were included in this study. The retinal detachments were not total. None of the patients had pathologic myopia or a history of ocular surgery. The fellow eyes were ophthalmoscopically normal and used as controls. Attached retinal sites of the eyes with a retinal detachment and the corresponding retinal sites of the fellow eyes were examined by OCT. Three OCT sections were taken from each eye, and thicknesses of three reflective zones corresponding to the inner part of the neurosensory retina (partial neurosensory retina), photoreceptor-photoreceptor outer segment, and total retinal thickness on each OCT section were measured and compared with those of the fellow eye. These three measurements were taken as the main outcome measures and performed on five different sites of each OCT section taken from each eye. RESULTS: The mean partial neurosensory retinal thickness of the attached retina in the eyes with a retinal detachment and the corresponding retinal sites in the fellow eyes was 172.74 +/- 14.23 microm and 170.60 +/- 16.51 microm, respectively. There was no statistically significant difference between these two values. The mean photoreceptor outer segment thickness of the attached retina in the eyes with a retinal detachment and the corresponding retinal sites in the fellow eyes was 62.74 +/- 12.02 microm and 58.23 +/- 15.14 microm, respectively. There was a statistically significant difference between these two values. The mean total retinal thickness of the still-attached retina in the eyes with a retinal detachment and the corresponding retinal sites in the fellow eyes were 293.23 +/- 27.87 microm and 277.06 +/- 19.12 microm, respectively. There was a statistically significant difference between these two values. CONCLUSIONS: The main difference between the two groups of eyes was at the level of the thickness of the black hyporeflective zone, corresponding anatomically to the photoreceptor and photoreceptor outer segment that enlarges in the retinal detachments. Therefore, there may be a subclinical retinal detachment or a global retinal relaxation even in the ophthalmoscopically normal-appearing, still-attached retina. This may be the underlying cause of preoperative and postoperative signs and symptoms. Additional studies are required to confirm these findings.  相似文献   

16.
OBJECTIVE: To describe the optical coherence tomography (OCT) findings of choroidal nevi. METHODS: Retrospective, single-center case series of 120 eyes of 120 consecutive patients with choroidal nevi who were evaluated by OCT. Diagnostic imaging was performed with a Zeiss StratusOCT Model 3000 (Carl Zeiss Ophthalmic Systems, Dublin, CA) using scan acquisition protocols of 6 radial lines and retinal thickness analysis overlying the nevus. RESULTS: The mean patient age was 59 years (median, 60 years; range, 14-87 years). The choroidal nevus was a mean of 5.2 mm in basal dimension and 1.7 mm in thickness and was located a mean of 2.7 mm from the optic disk and 2.5 mm from the foveola. Related retinal findings by ophthalmoscopic evaluation included overlying retina edema (3%), subretinal fluid (16%), retinal thinning (0%), drusen (58%), and retinal pigment epithelium (RPE) detachment (2%). In comparison, related retinal findings at the site of the nevus by OCT included overlying retina edema (15%), subretinal fluid (26%), retinal thinning (22%), drusen (41%), and RPE detachment (12%). Furthermore, OCT permitted classification of the overlying retinal edema as focal cystoid (3%), diffuse cystoid (8%), coalescent cystoid (3%), and noncystoid edema (1%). By OCT, the overlying retina was normal thickness (32%), thinned (22%), or thickened (45%), and photoreceptor loss or attenuation was noted in 51% of cases. Specific OCT findings of the choroidal nevus were limited to its anterior surface with minimal penetration into the mass. These findings included increased thickness of the RPE/choriocapillaris layer (68%) and optical qualities within the anterior portion of the nevus of hyporeflectivity (62%), isoreflectivity (29%), and hyperreflectivity (9%). Hyporeflectivity was observed in 68% of pigmented nevi and 18% of nonpigmented nevi. When comparing OCT with clinical examination, OCT was more sensitive in the detection of related retinal edema, subretinal fluid, retinal thinning, photoreceptor attenuation, and RPE detachment. CONCLUSIONS: OCT is a useful diagnostic modality for imaging the retina overlying a choroidal nevus. Numerous overlying changes such as subretinal fluid, retinal edema, retinal thinning, and photoreceptor attenuation are visible by OCT.  相似文献   

17.
目的 探讨成人弱视眼黄斑部视网膜厚度与正常眼的差异.方法 使用光学相干断层成像技术分别对弱视眼组(47例,65眼)与正常眼组(35例,70眼)黄斑区进行水平和垂直扫描,测定黄斑中心小凹和距离中心小凹鼻侧、上方、颞侧、下方700 μm的中心凹区及1000 μm黄斑旁中心凹区的视网膜厚度,所得数据进行t检验分析.结果 弱视眼组黄斑中心小凹及距离中心小凹鼻侧、上方、颞侧、下方700 μm视网膜厚度分别为(153.45±12.37)μm、(257.68±12.73)μm、(263.27±15.17)μm、(247.55±13.62)μm、(262.41±16.37)μm,正常眼组相应位置的视网膜厚度分别为(142.27±9.61)μm、(251.39±16.29)μm、(254.92±13.83)μm、(240.27±14.54)μm、(256.71±15.81)μm,弱视眼视网膜厚度较正常眼大,差异均有统计学意义(t=5.39、2.49、3.34、2.99、2.05,P〈0.05);弱视眼距离中心小凹鼻侧、上方、颞侧、下方1000 μm视网膜厚度分别为(262.09±13.67)μm、(266.46±12.76)μm、(252.11±13.47)μm、(264.32±15.23)μm,正常眼组相应位置的视网膜厚度分别为(264.25±14.42)μm、(269.61±13.66)μm、(250.91±13.27)μm、(261.75±14.18)μm,两组相比差异无统计学意义(t=0.89、1.38、0.52、1.06,P〉0.05).结论 弱视患者的黄斑中心小凹及中心凹处视网膜较正常服厚,弱视的发生可能与黄斑中心小凹及中心凹处视网膜异常有关.  相似文献   

18.
PURPOSE: It is unknown whether the thickness of the retina depends on axial length or on age. We therefore used optical coherence tomography (OCT) to study this relationship. METHODS AND MATERIALS: We recruited 159 subjects aged 13-92 years (205 eyes) without macular pathology. OCT measurements included three horizontal scans and one vertical scan through the fovea. Axial length was determined by an analog high-resolution biometric unit. RESULTS: There was no correlation between retinal thickness and either axial length or age. Mean retinal thickness in the fovea was 142 +/- 18 microns. In the nasal retina thickness was significantly increased to 266 +/- 17 microns, compared to 249 +/- 18 microns in the temporal retina. Retinal thickness in subjects' two eyes was significantly correlated. CONCLUSIONS: Since retinal thickness does not depend upon age or length of the eye, no corrections are necessary when analyzing pathological retinal thickening, such as in diabetic retinal disease.  相似文献   

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