高度近视患者黄斑部视网膜厚度光学相干断层扫描分析

目的探讨高度近视黄斑部视网膜厚度地形图的特点。方法高度近视患者共49例(79只眼),按屈光度分成三组,第Ⅰ组(-6.00D~-12.00D),第Ⅱ组(-12.00D~-18.00D),第Ⅲ组(>-18.00D),采用TOPCON 3DOCT-1000光学相干断层扫描系统检测黄斑区9区域视网膜厚度,并进行相关性分析。结果高度近视患者黄斑区各区域视网膜厚度与屈光度相关,各组之间差异均有统计学意义(P<0.05);内环各区的视网膜厚度均大于外环,差异有统计学意义(P<0.05);视网膜厚度与年龄、矫正视力相关(P<0.05);与性别、眼别无关(P>0.05)。结论高度近视患者黄斑部视网膜厚度随屈光度的增加及矫正视力降低而逐渐变薄,其中外环厚度变化更明显,且与年龄增长呈负相关。视网膜厚度与眼别、性别没有相关性。     

光学相干断层扫描对2型糖尿病患者视网膜神经变性的早期评估价值

目的 采用光学相干断层扫描（OCT）检测无糖尿病性视网膜病变（DR的2型糖尿病（T2DM）患者在糖尿病视网膜神经变性（DRN）早期的视网膜神经厚度变化。方法 采用横断面研究,选取2022年1—10月医院收治的32例无DR的T2DM患者（共32眼）作为试验组,以年龄、性别匹配的32名健康者（32眼）作为对照组。将黄斑区分为9个区域（中央区、上方内环区、颞侧内环区、下方内环区、鼻侧内环区、上方外环区、颞侧外环区、下方外环区和鼻侧外环区）,采用OCT检测以上区域的黄斑视网膜神经纤维层（mRNFL）、神经节细胞层（GCL）、内丛状层（IPL）、视网膜厚度,并进行比较;将视盘分为4个区域（上方、下方、鼻侧、颞侧）,采用OCT检测视盘视网膜神经纤维层（pRNFL）厚度,以及全周pRNFL平均厚度,并对两组各指标比较。结果 黄斑区9个区域中,试验组下方外环区、鼻侧外环区mRNFL厚度低于对照组,中央区、上方内环区、颞侧内环区、下方内环区、鼻侧内环区的GCL厚度低于对照组,上方内环区、颞侧内环区、下方内环区、鼻侧内环区的IPL厚度低于对照组,差异均有统计学意义（P<0.05）;两组黄斑区9个区域...     

神经纤维层厚度与屈光不正和年龄的关系研究

目的 运用偏相关分析评估通过光学相干断层扫描（OCT）测量健康人神经纤维层厚度（RNFL）与屈光不正和年龄的相关性.方法 对106例健康受试者的右眼的各个钟点、各象限和整个RNFL平均厚度进行横断面分析,其中高度近视33例（SE〈-6.0 D）,中度近视60例（-6.0 D≤SE〈-3.0 D）,低度近视和正视眼13例（-3.0 D≤SE〈0.5 D）,用偏相关分析来评估RNFL和等效球径（SE）和年龄的相关性.结果 高度近视眼中平均RNFL厚度（95.74±13.46）μm比中度近视眼（101.43±11.53）μm以及低度近视和正视眼（108.06±8.42）μm的RNFL厚度要薄（P〈0.05）.1、5、6和12钟点处以及上下方象限的RNFL厚度和平均RNFL厚度与SE呈正相关（r=0.36,0.33,0.43,0.29,0.28,0.39,P〈0.01,r=0.22,P〈0.05）,而8、9和10点处以及颢侧象限的RNFL厚度随着近视的发展与SE呈负相关（r=-0.21,P〈0.05,r=-0.36,P〈0.01;r=-0.24,P〈0.05;r=-0.30,P〈0.01）.2、3、4、6钟点处以及鼻侧和下方RNFL厚度的变化同年龄具有相关性（r=-0.20,-0.20,-0.20,P〈0.05,r=0.31,P〈0.01）.结论 RNFL厚度随着屈光不正和年龄的变化而变化,运用RNFL厚度评估青光眼要考虑屈光状态和年龄,同时要了解RNFL厚度变化所在的位置.     

近视眼视网膜神经纤维层厚度与中央角膜厚度相关性研究

目的 探讨近视眼患者视网膜神经纤维层（RNFL）厚度与中央角膜厚度（CCT）之间的关系.方法 选择91例眼科门诊近视患者（91眼）,其中低度近视（等效球镜度数[SE]＞-3.0D）28例（28眼）,中度近视（SE-0.3D～-6.0D）33例（33眼）,高度近视（SE＜-6.0D）30例（30眼）.均接受包括眼压、验光、裂隙灯、眼底等常规眼部检查,排除除屈光不正以外其他眼部疾病.利用RTVue Fourior OCT（Optovue Inc,USA）测量视盘周围RNFL厚度;利用CAM-L模块测量CCT.结果 近视眼患者RNFL厚度是（108.5±10.1）μm,CCT是（524.7±36.8）μm,在低中高近视组差异均无统计学意义（P＞0.05）.单因素相关及多元线性回归分析发现：颞侧（tl1,tu1）RNFL厚度与CCT呈正相关（tl1单因素及多因素r=0.281,0.093;tu1单因素及多因素r=0.352,0.163;P＜0.05）;鼻侧（nl2,nu2）和下方偏鼻侧（in2,in1）区域RNFL厚度与SE呈正相关（P＜0.05）;下方偏颞侧（it2）RNFL厚度与SE呈负相关（P＜0.05）;其他部位RNFL厚度与CCT、SE无相关（P＞0.05）.结论 近视眼视盘周围局部区域RNFL厚度与CCT存在相关性,表明中央角膜厚度与青光眼视神经病变敏感结构指标具有一定关系,对青光眼诊治具有重要指导意义.     

近视眼视网膜神经纤维层厚度与中央角膜厚度相关性研究

Objective To explore the relationship between retinal nerve fiber layer (RNFL) thickness and central corneal thickness (CCT) in myopia eyes.Methods 91 cases (91eyes) were selected from ophthalmological outpatients including 28cases with low myopia ( spherical equivalence [ SE ] ＞ -3.0D), 33 cases with moderate myopia (SE -0.3D ～ -6.0D) and 30 cases with high myopia (SE ＜ -6.0D).All patients received ocular standard examination including intraocular pressure, refraction, slitlamp biomicroscopy and fundus examination.Other ocular diseases except refractive error were excluded.RNFL thickness and CCT were measured by RTVue Fourior-OCT ( Optovue Inc, USA).Refraction diopter was shown as SE.Results The mean RNFL thickness and CCT was ( 108.5 ± 10.1 ) μm, (524.7 ±36.8)μm respectively.These were no significantly different among low, moderate and high myopia ( P ＞ 0.05 ).Temporal RNFL thickness( tl1 ,tu1 ) was significantly positive related with CCT( r =0.281,0.093 of tl1, r= 0.352,0.167 of tu1 respectively in single and multiple variable analysis; P ＜ 0.05 ), nasal ( nl2, nu2)and inferior nasal RNFL thickness( in2,in1 )was significantly positive related with SE( P ＜0.05), inferior temporal RNFL thickness( it2)was significantly negative related with SE( P ＜0.05), and RNFL thickness in other regions were not significant related with CCT and SE ( P ＞ 0.05 ) in single and multiple variable regressive analysis.Conclusion Relationship between RNFL thickness of local paradisc region and CCT in myopia eyes suggested that CCT should be correlative with some sensible structural parameters in glaucomatous neuropathy and might be important in the diagnosis and therapy of glaucoma.     

近视眼视网膜神经纤维层厚度与中央角膜厚度相关性研究

Objective To explore the relationship between retinal nerve fiber layer (RNFL) thickness and central corneal thickness (CCT) in myopia eyes.Methods 91 cases (91eyes) were selected from ophthalmological outpatients including 28cases with low myopia ( spherical equivalence [ SE ] ＞ -3.0D), 33 cases with moderate myopia (SE -0.3D ～ -6.0D) and 30 cases with high myopia (SE ＜ -6.0D).All patients received ocular standard examination including intraocular pressure, refraction, slitlamp biomicroscopy and fundus examination.Other ocular diseases except refractive error were excluded.RNFL thickness and CCT were measured by RTVue Fourior-OCT ( Optovue Inc, USA).Refraction diopter was shown as SE.Results The mean RNFL thickness and CCT was ( 108.5 ± 10.1 ) μm, (524.7 ±36.8)μm respectively.These were no significantly different among low, moderate and high myopia ( P ＞ 0.05 ).Temporal RNFL thickness( tl1 ,tu1 ) was significantly positive related with CCT( r =0.281,0.093 of tl1, r= 0.352,0.167 of tu1 respectively in single and multiple variable analysis; P ＜ 0.05 ), nasal ( nl2, nu2)and inferior nasal RNFL thickness( in2,in1 )was significantly positive related with SE( P ＜0.05), inferior temporal RNFL thickness( it2)was significantly negative related with SE( P ＜0.05), and RNFL thickness in other regions were not significant related with CCT and SE ( P ＞ 0.05 ) in single and multiple variable regressive analysis.Conclusion Relationship between RNFL thickness of local paradisc region and CCT in myopia eyes suggested that CCT should be correlative with some sensible structural parameters in glaucomatous neuropathy and might be important in the diagnosis and therapy of glaucoma.     

傅立叶光学相干断层扫描测量黄斑区节细胞复合体及视网膜神经纤维层厚度对青光眼的诊断意义

目的 探讨黄斑区节细胞复合体（macular ganglion cell complex,mGCC）和视盘周围视网膜神经纤维层（peripapillary retinal nerve fiber layer,pRNFL）厚度在青光眼中的变化情况及诊断能力.方法 选择本院眼科门诊成年患者,所有受试者均接受青光眼常规项目检查.使用傅立叶光学断层扫描（optic coherence tomography,OCT）测量pRNFL及mGCC各参数.结果 受试者共116例（116眼）,包括正常组51例（44.0%）,早期青光眼组30例（30.2%）,进展期青光眼组35例（25.9%）,正常组、早期及进展期青光眼组的pRNFL、mGCC各参数的差异均有统计学意义（F=83.022、97.361、27.899、79.585、140.686、119.166、116.234、90.855、64.341、133.064,P＜0.01）.对于早期青光眼,除鼻侧之外（P＞0.05）,其余pRNFL及所有mCCC参数的受试者曲线下面积（Area under Receive Operated Curve,AROC）差异均有统计学意义（pRNFL：0.796±0.049;mGCC：0.748±0.055,P＜0.05）.对于总体青光眼,所有pRNFL及mGCC参数的AROC差异均有统计学意义（pRNFL：0.889±0.029;mGCC：0.862±0.034,P＜0. 01）.经AROC两两比较,除了颞侧、上方pRN-FL厚度较mGCC中局部丢失体积（focal loss of volume,FLV）具有较好的诊断能力（P＜0.05）,大部分pRNFL及mGCC参数之间的诊断能力差异无统计学意义（P＞0.05）.结论 在傅立叶OCT中,pRNFL仍是青光眼最主要检测方法,mGCC可作为一种有用的青光眼补充诊断手段.     

光学相干断层成像在健康体检中应用的初步探讨

光学相干断层扫描（OCT）是近几年发展起来的一种新兴的非损伤性、非接触性眼科影像学检查方法,它可对视网膜细微结构进行横截面扫描,能清晰显示视网膜不同层次的结构并能对视网膜的细微结构进行客观、定量的测量和分析。对视网膜疾病,尤其是黄斑疾病的诊断、鉴别诊断、病情的监测以及定量评估、治疗方案的选择等方面具有重要的应用价值[1-6]。     

荧光血管造影与视网膜光学相干断层扫描图像分析在糖尿病性黄斑水肿的临床研究

目的探讨眼底荧光血管造影（FFA）及黄斑区视网膜光学相干断层扫捕（OCT）检查存糖尿病性黄斑水肿中的研究结果,并对其所得罔像进行分析。方法现对诊断为糖尿病视网膜病变的患者100例进行眼底荧光血管造影（FFA）及黄斑区视网膜光学相干断层扫描（OCT）检查。结果100例糖尿病黄斑水肿的患者中：FFA有异常表现者占71％,未见异常者占29％。OCT图像显示视网膜水肿占82％,正常黄斑结构占18％。结论与荧光血管造影等检查相比较,OCT能更直观地显示黄斑的形态结构及组织病理变化,为糖尿病黄斑水肿的早期诊断提供客观依据,以及时指导临床治疗。     

扫频源光学相干断层扫描和时域光学相干断层扫描对近视患者房角参数测量的一致性分析

目的：探讨扫频源光学相干断层扫描(SS-OCT)和时域光学相干断层扫描(TD-OCT)在近视患者前房角测量的一致性。方法：回顾性选择2023年1-5月在陆军军医大学大坪医院眼科就诊的46(92眼)近视患者,所有患者均使用SS-OCT和TD-OCT分别对房角参数进行测量,对比分析SS-OCT和TD-OCT两种扫描方法测量中央前房深度(ACD)、房角开放距离(AOD₅₀₀、AOD₇₅₀)、巩膜突角度(SSA)、小梁网虹膜面积(TISA₅₀₀、TISA₇₅₀)等参数的差异;采用Pearson相关性分析法和Bland-Altman检验,分析测量的相关性和一致性。结果：两种扫描方法测量房角参数ACD比较差异均有统计学意义(t=-6.83,P<0.001);且AOD₅₀₀、AOD₇₅₀、SSA₅₀₀、TISA₅₀₀和TISA₇₅₀的鼻侧测量数据差异均有统计学意义(t=-5.16、5.51、-6.5...     

频域OCT在病理性近视眼黄斑区神经上皮层厚度检测中的分析研究

目的应用频域OCT（光学相干断层扫描成像,Optical coherence tomography）技术分析研究病理性近视眼黄斑区视网膜神经上皮层厚度的变化特点。方法选取2012年2—12月在该院眼科行黄斑区频域OCT检查的病理性近视眼患者63例（63眼）作为观察组和正常眼患者54例（54眼）作为对照组,对其黄斑区视网膜进行测量,记录黄斑区9个分区的视网膜神经上皮层的平均厚度。结果 A1、A5区察组（病理性近视眼组）和对照组（正常眼组）之间的差异均无统计学意义（均为P〉0.05）;A2、A3区观察组（病理性近视眼组）均低于对照组（正常眼组）,P〈0.05,两组间的差异均有统计学意义;A4、A6、A7、A8、A9区,观察组（病理性近视眼组）均低于对照组（正常眼组）,P〈0.01,两组间的差异均有显著的统计学意义。结论病理性近视对视网膜特别是黄斑部的影响是确实存在的,频域OCT能够精确量化该厚度的变化。     

光学相干层析成像技术及在医学中的应用

叙述了光学相干层析成像技术的基本原理，特别介绍了实现光学相干层析成像的两种方法。对光学相干层析成像技术的现状、存在的问题、新进展和临床医学上应用也进行了讨论。     

原发性开角型青光眼与高度近视可疑青光眼患者视网膜厚度的比较研究

目的观察原发性开角型青光眼与高度近视可疑青光眼患者间视网膜神经纤维层厚度之间的差异。方法应用视网膜厚度分析仪对17例原发性开角型青光眼及18例高度近视可疑青光眼患者的后极部视网膜厚度进行了分析比较。结果原发性开角型青光眼及高度近视可疑青光眼患者间平均视网膜神经纤维层厚度差异有显著性意义,而后极部及中心凹周围最薄的视网膜厚度差异无显著性。结论视网膜厚度分析仪为原发性开角型青光眼的早期诊断提供了一种新的检查手段。     

光学相干断层扫描定量糖尿病性黄斑水肿的黄斑厚度及与视功能相关分析

目的 观察糖尿病性黄斑水肿(DME)的光学相干断层扫描(OCT)临床特征,并探讨其与视功能改变的相关性.方法 40例49眼DME患者(DME组)及31例31眼无DME患者(对照组)分别应用OCT进行黄斑厚度定量分析,同时采用图形视觉诱发电位(P-VEP)及黄斑10°视野平均缺损(MD)指数检查视功能,根据DME组有无合并增生型糖尿病视网膜病变分为A组(非增生型糖尿病视网膜病变+DME,30眼)和B组(增生型糖尿病视网膜病变+DME,19眼).结果 DMEOCT图像定量分析发现,DME组黄斑厚度[(299.25±63.87)μm]较对照组[(204.35±37.94)μm]增厚,且视力、MD指数受损更为严重,其差异有统计学意义(P＜0.05).A组与B组的黄斑厚度、视力、MD指数比较差异均无统计学意义(P＞0.05);OCT黄斑厚度与视力存在线性负相关(r=-0.437,P＜0.05);OCT黄斑厚度与MD指数存在线性正相关(r=0.441,P＜0.05).结论 OCT为评估DME的发生、发展及疗效判断提供了一种有效、客观的检测手段,随着黄斑厚度的增加,视功能指标中视力下降、黄斑10°视野受损程度加重.

Abstract：

Objective To explore the clinical features of diabetic macular edema (DME) with optical coherence tomography (OCT) and correlation with visual function. Methods Forty-nine eyes from 40 patients with DME (DME group) and 31 eyes from 31 patients without DME (control group) were examined with OCT,pattern reversal visual evoked potentials (P-VEP),macular perimetry. According to proliferative diabetic retinopathy (PDR), 49 eyes with DME were divided into group A (without PDR, 30eyes) and group B (with PDR, 19 eyes). Results The retinal macular thickness of central fovea in DME group [(299.25±63.87)μm] was more than that in contol group [(204.35 ± 37.94)μm], visual acuity and macular visual field in DME group were significantly different than those in control group, respectively (P ＜ 0.05). The retinal macular thickness of central fovea,visual acuity and visual field were no significant differences between group A and group B (P＞0.05). OCT macular thickness and visual correlation coefficient was -0.437(P＜ 0.05 ); OCT macular thickness and mean defect correlation coefficient was 0.441(P ＜ 0.05). Conclusions OCT can provide a useful tool for monitoring the occurrence and development of DME, can assess the response to treatment. With increasing of the macular retinal thickness, the visual acuity and macular visual field of visual function are more damaged.     

Adaptive replanning intensity-modulated radiotherapy for choroidal metastasis of breast cancer using optical coherence tomography

Swept source optical coherence tomography (SS-OCT) is a convenient method for precise, early-stage detection of choroidal metastatic lesions, involving assessment of tumor response, and for regular follow-up studies. Using information obtained with SS-OCT, we performed intensity-modulated radiotherapy (IMRT) for a patient with choroidal metastasis from breast cancer with more accuracy than had been previously possible. We made replanning adaptive radiotherapy (ART) three times based on the rapid tumor shrinkage detected by weekly assessments with SS-OCT. Accordingly, the planning target volume (PTV) decreased from 1.6 cm³ to 0.61 cm³ (38%), with 0.95 cm³ (59%) and 0.75 cm³ (46%) as intermediate values during the treatment course. The D_{0.1 cm3} of the right optic nerve was also reduced from 1.70 Gy/fraction to 0.69 Gy/faction, with 1.41 Gy/fraction and 1.29 Gy/fraction as intermediate values. Adaptive replanning IMRT made it possible to perform locally curative treatment of the metastatic choroidal lesion with a higher dose for the PTV, and a lower dose for organs at risk (OARs).     

基于扫频激光光源的皮肤血流OCT成像系统研制与应用

目的 :针对皮肤组织的光谱吸收特性,研制一套基于扫频激光光源的皮肤血流光学相干断层扫描(optical coherence tomography,OCT)成像系统,实现皮肤组织2D/3D结构成像及微血管血流成像。方法 :该系统由扫频激光光源及干涉仪组成的光学系统模块、光电探测器及数据采集卡组成的信号采集模块、计算机及控制卡组成的系统控制模块以及图像处理模块构成。系统采用中心波长为1 310 nm的扫频激光光源,通过对采集到的与皮肤组织结构及微血管血流相关的光相干扫描信号进行色散补偿、逆傅里叶变换及去相关标准差运算等数据处理,实现皮肤组织结构与微血流成像。结果:利用该系统对人体皮肤组织进行实时成像研究,其扫描频率为100 kHz,纵向分辨力可达6μm,可清晰显示皮下分层与血管组织;利用去相关标准差算法处理,该系统可实现皮下微血流信息的提取与成像。结论:该系统实现了皮肤组织结构与微血流成像,为浅表皮肤病与外周动脉疾病的临床诊断奠定了实验基础。