视网膜色素变性的视网膜电图与光学相干断层扫描的观察分析

目的:观察视网膜色素变性(retinitis pigmentosa,RP)的全视野视网膜电图(global electroretinogram,ERG)、多焦视网膜电图(multifocal electroretinogram,mfERG)及视网膜光学相干断层扫描(optical coherence tomography,OCT)的图像特征及临床意义。方法:对临床确诊的RP患者组15例30眼和正常对照组15例30眼进行全视野ERG,mfERG与OCT检查,并对数据进行统计分析。结果:RP患者组全视野ERG显示b波潜伏期与正常对照组相比显著延长且b波振幅与正常对照组相比显著降低;mfERG各环的反应密度均低于正常对照组,且有显著性差异,3～5环的潜伏期与正常对照组相比显著延长。RP患者组OCT显示视网膜黄斑中心凹厚度平均值低于正常对照组,但二者比较,差异无统计学意义。结论:ERG可有效评价RP患者黄斑区及周边视网膜的功能,RP患者OCT断层扫描像与其已知的视网膜病变特点相一致。     

黄斑水肿的光相干断层扫描分析

目的 观察黄斑水肿的光相干断层扫描（OCT）图像特征；探讨黄斑中心凹厚度与最佳矫正视力之间的关系。 方法 对50例正常对照者以及47例54只经直接、间接检眼镜、三面镜及荧光素眼底血管造影（FFA）诊断为黄斑水肿的患眼进行OCT检查，通过黄斑中心凹的水平或垂直方向线性扫描，测量黄斑中心凹的厚度，对比分析两组受检者的黄斑形态及中心凹厚度值，根据形态学特点对黄斑水肿者的OCT图像进行分类并将其中心凹厚度与其最佳矫正视力进行相关分析。 结果 正常对照组与黄斑水肿组黄斑形态及中心凹厚度差异有显著性的意义。黄斑水肿患眼的OCT图像表现为3种特征，20只眼表现为黄斑区视网膜海绵样肿胀，占37.1%；26只眼表现为黄斑囊样水肿，占48.1%；8只眼表现为浆液性视网膜神经上皮脱离，占14.8%。黄斑水肿者黄斑中心凹厚度与其最佳矫正视力呈负相关（r=－0.569, P=0.000）。 结论 黄斑水肿的OCT图像主要包括视网膜海绵样肿胀、黄斑囊样水肿及神经上皮浆液性脱离。黄斑水肿患者的黄斑中心凹厚度明显增厚，黄斑中心凹厚度越厚，视力越差。 （中华眼底病杂志，2004，20：152-155）     

原发性视网膜色素变性的频域光学相干断层成像特征

目的观察原发性视网膜色素变性即色素性视网膜炎(retinitis pigmentosa,RP)的频域光学相干断层扫描检查(fourier-domain optical coherence tomography,FD-OCT)的图像特征。方法回顾性分析经临床确诊的30例60眼RP患者及30例60眼正常人FD-OCT检查资料,比较分析视网膜厚度及图像特征。结果正常组黄斑中心视网膜厚度为(174.6±14.9)μm;RP组黄斑中心视网膜厚度为(146.0±21.5)μm;RP组黄斑中心视网膜厚度较正常组降低,两组比较差异有统计学意义(t=3.487,P=0.001)。RP患者骨细胞样视网膜色素沉着区FD-OCT图像可见病变区色素上皮层光带断裂,与其相对应的神经上皮层可见增殖移行的色素上皮,黄斑区FD-OCT图像见光感受器内外节连接层反射部分或全部消失伴视网膜色素上皮层萎缩变薄。RP组中伴神经上皮层弥漫水肿5眼;黄斑囊样水肿3眼;黄斑前膜17眼。结论 FD-OCT可显示RP的组织病理改变,其影像学特征对临床诊断及病程估计有重要意义。     

OCT观察视网膜色素变性患者黄斑中心凹厚度变化及黄斑部图像特点

目的:通过光学相干断层扫描(optical coherence tomography,OCT)观察视网膜色素变性(retinitis pigmentosa,RP)患者黄斑中心凹的厚薄改变及黄斑部图片特点.方法:选取2014-09/2016-09在本院门诊确诊的RP患者74例148眼,同时选取50例100眼正常人作为对照.对两组进行OCT检测和眼底拍照,观察患者视网膜黄斑部位的图像特征,并对患者眼底拍照的结果进行对比,测量黄斑中心凹颞侧面4mm位置、乳头黄斑束中点及黄斑中心凹厚度.结果:对两组研究对象测量视网膜厚度显示,RP患者黄斑中心凹视网膜和中心凹颞侧部4mm厚度与正常人相比,差异无统计学意义(P>0.05);RP患者乳头黄斑束中点厚度变薄,与正常人对比差异有统计学意义(P<0.05);RP患者黄斑区OCT检测图像表征有5种类型:视网膜黄斑区域水肿者19例38眼;视网膜色素脉络膜毛细血管层和上皮层变薄者18例36眼;视网膜色素上皮层发生萎缩者12例24眼;黄斑部视网膜厚度正常者12例24眼;色素上皮层厚薄表现不一者13例26眼.结论:OCT能在前期及时地发现RP患者黄斑部位的病变,帮助患者深入了解病情发展,为患者早期诊疗提供了临床依据.     

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.     

Optic Coherence Tomography of Idiopathic Macular Epiretinal Membranes

OBjectives:To study the characteristics of optical coherence tomography(OCT) in idiopathic macular epiretinal membranes(IMEM)and the relationship between the thickness of fovea and the vision of affected eyes.Methods:A total of 67 cases(73 eyes)with clinical diagnisis of IMEM using direct indirect ophthalmoscope,three mirror contact lens,fundus color photography or nfundus fluorescein angiography(FFA) were examined with OCT.Results:Epiretinal membranes(ERMs)with macular edema were found in 32 eyes, proliferative ERMs in 20 eyes,ERMs withmacular pseudoholes in 14 eyes and ERMs with laminar macular holes in 7eyes.Based on OCT,the ERMs were clearly and partially seperated from the retinal (27 eyes,38.36%),the retinal thickness of the fovea was the thickest in the proliferative ERMs and the thinnest in the ERMs with laminar macular holes.The statistical analysis showed there was a negative correlation between the thickness of fovea and visual acuity (r=-0.454,P=0.000).Conclusion:There were four types of images of OCT in IMEM:ERMs with macular edema,proliferative ERMs,ERMs with macular pseudohole and ERMs with laminar macular hole;and the thicker the fovea under the OCT,the poorer the vision acuity in the affected eyes with ERMs.     

视网膜脱离手术前后黄斑区光学相干断层成像图形特征观察

目的 :观察孔源性视网膜脱离手术前后黄斑区光学相干断层成像 (OCT)的形态特征及临床应用价值。方法 :对 2 8例 2 8眼孔源性视网膜脱离PVRB级以下的患者手术前后黄斑区中心凹进行OCT检查 ,对其图像及与手术前后视力进行分析。结果 :根据 2 8例患者术前临床观察及OCT扫描图像可分为两组四型 ;术后OCT检查显示有 11例 (3 9 2 9% )患者视网膜下仍有微量积液 ;两组四型黄斑中心凹平均RNFL比较无显著性差异 (P >0 0 5 )。结论 :OCT作为一种高分辨率的在眼内获得活体组织横断面的检查仪器 ,能直观、清晰地显示视网膜脱离手术前后黄斑区视网膜横断面的形态特征 ,发现一些临床不易观察的眼底细微改变 ,如黄斑区视网膜神经上皮下微量的积液、视网膜的水肿、囊腔样改变等     

特发性黄斑视网膜前膜的光学相干断层扫描

目的观察特发性黄斑视网膜前膜(idiopathic macular epireti nal membranes, IMEM)的光学相干断层扫描(optical coherence tomography, OCT)图像 特征,探讨IMEM患眼黄斑中心凹厚度与视力之间的关系。方法对67例73只经直接或间接检眼镜、三面镜、眼底彩色照相或荧光素眼底血管造影(fundus fluorescein angiogrphy, FFA)检查诊断为IMEM的患眼进行经黄斑中心凹的OCT线性扫描, 测量黄斑中心凹厚度,并与视力进行相关分析。结果32只眼表现为视网膜前膜(Epiretinal menmbrabces, ERMs)伴黄斑水肿;20只眼表现为增生性ERMs,14只眼表现为ERMs伴假性黄斑裂孔;7只眼表现为ERMs伴板层黄斑裂孔。73只眼中27只眼可见ERMs与视网膜内层分离,占38.36%。增生性ERMs者黄斑中心凹厚度 最厚,ERMs伴板层黄斑裂孔者黄斑中心凹厚度最薄。黄斑中心凹厚度与视力呈负相关(r=－0.454,P=0.000)。结论IMEM 的 OCT图像主要有ERMs伴黄斑水肿、增生性ERMs、ERMs伴假性裂孔与板层裂孔改变;ERMs患者黄斑中心凹厚度越厚视力越差。(中华眼底病杂志,2001,17:115-118)     

Stargardt病的频域相干光断层扫描图像分析

目的 应用频域相干光断层扫描(OCT)技术评价Stargardt病患者黄斑区视网膜容积与中心视力之间的关系.方法 回顾性病例系列研究.收集10例(20只眼)Stargardt病的临床资料进行回顾性分析.所有患者均使用频域OCT分别测量黄斑中心凹区视网膜厚度、黄斑中心凹区光感受器细胞内外节缺失宽度、黄斑中心凹区直径3 mm和1 mm范围内的视网膜容积.运用线性回归分析法,比较最小分辨角对数(logMAR)视力与黄斑中心凹区视网膜厚度、黄斑中心凹区光感受器细胞内外节(IS/OS)缺失宽度、黄斑中心凹区直径3 mm和1 mm范围内视网膜容积的关系.结果 18只眼的logMAR视力为0.30～1.22,黄斑中心凹区光感受器细胞内外节缺失宽度为847～5306μm,黄斑中心凹区视网膜厚度为20～126 μm,黄斑中心凹区直径3 mm和1 mm范围内的视网膜容积分别为1.06～1.76 mm3、0.06～0.13 mm3.logMAR视力与黄斑中心凹区光感受器细胞内外节缺失宽度呈正相关(r=0.695,P＜0.05),与黄斑中心凹区视网膜厚度呈负相关(r=-0.601,P＜0.05),与黄斑中心凹区直径3 mm范围内的视网膜容积呈负相关(r=-0.725,P＜0.05),与黄斑中心凹区直径1 mm范围内的视网膜容积无相关性(r=-0.364,P＜0.05).结论 频域OCT技术可以清晰观察Stargardt 病患者各层视网膜结构,频域OCT检测获得的黄斑区视网膜容积与中心视力间存在一定的相关性.

Abstract：

Objective To assess the relationship between central visual acuity and retinal volume of macular fovea in patients with Stargardt disease by spectral-domain optical coherence tomography ( SD OCT). Methods It was a retrospective case series study. Twenty eyes of 10 patients with Stargardt disease were investigated by three-dimensional spectral-domain optical coherence tomography. SD OCT images were obtained and retrospectively analyzed. The retinal volumes of macular fovea were measured by SD OCT,whose diameters were set as 3 mm and 1 mm separately ( volume 3 and volume 1). The retinal thickness of macular fovea (macular thickness) and the width of IS/OS conjunction loss of macular fovea (IS/OS loss)were also measured by SD OCT. We correlated the logMAR BCVA with IS/OS loss, macular thickness,volume 3 and volume 1 by linear regression analysis. Results LogMAR BCVA was from 0. 3 to 1. 22.IS/OS loss was from 847 μm to 5306 μm. Macular thickness was from 20 μm to 126μm. Volume 3 and volume 1 was from 1. 06 to 1. 76 mm3 and 0. 06 to 0. 13 mm3. LogMAR BCVA correlated with the IS/OS loss (r = 0.695,P＜0. 05) , macular thickness (r= - 0. 601 ,P ＜ 0. 05), and volume 3 ( r = -0.725,P＜0. 05 ). LogMAR BCVA did not correlate with volume 1 ( r = - 0. 364, P ＞ 0. 05). Conclusions SD OCT could demonstrate the retinal structure of Stargardt disease clearly. The retinal volume of macular fovea accessed by SD OCT correlated with the visual acuity of Stargardt disease.     

特发性黄斑前膜眼黄斑光敏度的激光扫描检眼镜微视野检测

目的 观察激光扫描检眼镜（SLO）黄斑光敏度检查在评估特发性黄斑前膜眼视功能中的作用以及黄斑光敏度与中心视力、黄斑中心凹厚度的相互关系。 方法 用SLO的微视野(microperimetry)程序对直接检眼镜、前置镜以及光相干断层扫描（OCT）检查确诊的特发性黄斑前膜患者44例55只患眼进行黄斑中心10°视野光敏度检测，并与同期同样方法检测的31只正常眼进行对比，观察特发性黄斑前膜眼黄斑光敏度变化与OCT测量的中心凹厚度及对数视力检查结果的相互关系。 结果 特发性黄斑前膜眼黄斑光敏度较正常对照眼下降，其差异有统计学意义（F=47.265，P<0.01）。平均光敏感度下降与视力下降呈正相关性(r=0.687, P=0.000)；与黄斑中心凹视网膜厚度的增加呈负相关性（r=-0.532，P=0.003）。有视物变形眼较无视物变形眼的黄斑光敏度下降，差异有统计学意义（t=7.039, P=0.000）；增生性前膜眼较水肿性前膜眼平均黄斑光敏度均下降，但差异无统计学意义（t=-1.706, P=0.094）。 结论 SLO的微视野程序能敏感的反映特发性黄斑前膜眼的黄斑视功能状况，定量评价黄斑光敏度的变化；黄斑光敏度变化与中心视力、黄斑中心凹厚度相关。 (中华眼底病杂志, 2006, 22: 100-102)     

577nm全视网膜光凝术对糖尿病视网膜病变黄斑的影响

目的：探讨577 nm全视网膜光凝术对糖尿病视网膜病变黄斑中心凹厚度的影响。方法：应用optovue光学相干断层扫描仪分析37例45眼增殖前期糖尿病视网膜病变( preproliferative diabetic retinopathy, PPDR )和增殖期糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者接受577nm全视网膜光凝术前和术后1,3,6 mo黄斑中心凹视网膜神经上皮层的厚度。结果：全视网膜光凝术后1,3mo,黄斑中心凹视网膜神经上皮层的厚度与术前相比较明显增厚,两者比较具有统计学差异(P<0.05);随访至术后6mo逐步恢复至光凝前的水平,没有统计学差异(P>0.05)。结论：577 nm全视网膜光凝术能够引起糖尿病患者黄斑中心凹神经上皮层厚度一过性增加,术后6 mo时逐渐恢复到术前的水平。     

Reduction of inner retinal thickness in patients with autosomal dominant optic atrophy associated with OPA1 mutations

PURPOSE: To determine the morphologic changes in the retina in the macula and around the optic disc in patients with autosomal dominant optic atrophy (ADOA) associated with a mutation in the OPA1 gene. METHODS: Cross-sectional images of the macular area of the retina were obtained by optical coherence tomography (OCT) in patients with ADOA who had a heterozygous mutation in the OPA1 gene. There were 15 eyes of eight patients from five families: four men and four women. The average age of the patients was 48.1 years. In the OCT images, the cross sections of the sensory retina were divided manually into four areas. The thickness of the overall sensory retina and the divided areas were measured at 1 and 2 mm on the temporal, nasal, superior, and inferior sides of the fovea as well as at the fovea. The thickness of the retinal nerve fiber layer (RNFL) around the optic discs was measured by taking circular scans (3.4 mm in diameter) centered on the optic disc. The results in the patients with ADOA were compared with those from 11 normal control subjects. RESULTS: The overall thickness of the sensory retina in the macular area was significantly thinner in the patients with ADOA than in the control subjects at all points except the fovea (P < 0.0001). The RNFL in the macular area in the patients with ADOA was significantly thinner than that in control subjects at all points (P < 0.0001), especially at 1 mm from the fovea. The circumpapillary RNFL was significantly thinner at the temporal, superior, and inferior areas in patients with ADOA but not in the nasal area. The total cross-sectional area of the circumpapillary RNFL was significantly correlated with visual acuity. The thickness of the combined ganglion cell layer, inner plexiform layer, inner nuclear layer, and outer plexiform layer in the macular area was significantly thinner in the patients (P < 0.0056). The thickness of the outer nuclear layer and the photoreceptor inner segments and the thickness of the photoreceptor outer segments were not significantly different between the patients with ADOA and normal control subjects. CONCLUSIONS: The RNFL and the layer including the ganglion cell layer are significantly thinner in patients with ADOA associated with an OPA1 gene mutation, whereas the photoreceptor layers are not affected morphologically. The inner retina is the main area of the retina altered in ADOA.     

无黄斑水肿的NPDR患者中心凹区mfERG与视网膜厚度的研究

目的：分析非增生性糖尿病视网膜病变(nonproliferative diabetic retinopathy,NPDR)无黄斑水肿的患者黄斑中心凹区视网膜功能及厚度间的关系。

方法：选取NPDR患者20例35眼患眼为糖尿病视网膜病变(diabetic retinopathy,DR)组,行多焦视网膜电图(multifocal electronic retinography, mfERG)及Spectralis 相干断层扫描(Spectralis optical coherence tomography,Spectralis OCT)检查。以15例20眼正常眼为OCT对照组,以19例20眼正常眼为mfERG对照组,OCT对照组做Spectralis OCT检查,mfERG对照组做mfERG检查。

结果：与对照组相比,DR组黄斑中心凹mfERG1环的P1波反应密度减小,P1波及N1波隐含期改变无统计学意义; DR组无水肿的黄斑中心凹视网膜厚度、神经上皮层厚度仍有显著增加。

结论：应用mfERG可以在视网膜无可见明显结构改变之前发现视网膜功能上的异常变化; Spectralis OCT可以测量视网膜各层厚度,反映视网膜精细结构变化,验证视网膜功能上的异常改变,二者联合应用为极早期发现糖尿病视网膜病变视功能改变提供有效的证据,并为及时治疗提供资料。     

日食性视网膜病变中的微小黄斑损伤

【摘要】 目的 观察日食性视网膜病变微小黄斑损伤的表现及预后。设计 回顾性病例系列。研究对象 2009年日食发生后就诊于北京同仁医院的黄斑损伤患者6例（11眼）。方法 回顾患者的临床表现及相干光断层扫描（OCT）、眼底自发荧光、多焦视网膜电图（mfERG）、微视野等检查结果,对其视力损害恢复情况以及黄斑病变辅助检查结果进行分析。随访2~18个月。主要指标 视力、OCT、眼底自发荧光检查结果。结果 6例（11眼）OCT检查均发现黄斑中心凹视网膜感光细胞内节和外节层（IS/OS层）断裂。其中7眼眼底自发荧光可见黄斑细小暗点,彩色眼底像表现为相应的细小黄点。微视野、mfERG和荧光素眼底血管造影检查未见异常。就诊时视力0.6~0.8,1周~1个月时视力均1.0以上。结论 OCT和眼底自发荧光检查能及时发现日食性视网膜病变中的微小黄斑损伤,此病视力恢复较好。（眼科,2012,21：244-247）     

玻璃体黄斑牵引综合征的三维频域相干光断层扫描图像特征

目的 探讨玻璃体黄斑牵引综合征的三维频域相干光断层扫描(OCT)图像特征.方法 回顾性系列病例研究.收集18例经三维频域OCT检查确诊的玻璃体黄斑牵引综合征患者的临床资料进行回顾性分析,着重观察其三维频域OCT检测图像特征.根据频域OCT定量检测的玻璃体与黄斑区视网膜附着粘连的范围,将玻璃体黄斑牵引综合征分为局灶型和宽大型两类.运用线性回归法分析所有患者的最小分辨角对数视力(logMAR视力)与黄斑中心凹部视网膜厚度的关系.结果 玻璃体黄斑牵引综合征患者的频域OCT检测图像清晰,其病变特征明显.18例患者中,病变呈局灶型14例,宽大型4例;合并黄斑前膜8例,合并黄斑全层裂孔2例,合并黄斑板层裂孔2例.18只眼的logMAR视力为0.15～1.22,其黄斑中心凹视网膜厚度为275～899 μm,经线性回归分析,显示所有患者的logMAR视力与黄斑中心凹的视网膜厚度呈中度线性正相关(r=0.616,P=0.007).结论 三维频域OCT检测可以直观地显示眼底病变三维结构,对玻璃体黄斑牵引综合征患者的诊断和随访具有重要作用.     

频域光学相干断层扫描对糖尿病患者黄斑部视网膜厚度分区测定的研究

目的应用频域OCT分区测量正常人及各期糖尿病视网膜病变患者黄斑部视网膜厚度、黄斑部视网膜的平均厚度及黄斑部的总体积,探讨2型糖尿病患者黄斑部视网膜厚度及体积的特点以及与正常人之间的相关性。方法 2010年1月至2011年9月在我院确诊的2型糖尿病患者185例(317眼),通过常规散瞳眼底检查、眼底照相及FFA检查并依据2002年糖尿病视网膜病变国际临床分型标准将这317眼2型糖尿病患者分为3组:糖尿病正常视网膜(NDR组)患者50例(89眼)、非增生性糖尿病视网膜病变(NPDR组)患者73例(126眼)、增生性糖尿病视网膜病变(PDR组)患者62例(102眼),第4组为正常组52例(98眼)。用频域OCT对上述4组进行黄斑部的扫描,并用分析软件进行九分区的自动分析,记录各区视网膜厚度数据和黄斑区视网膜平均厚度及黄斑区总的体积。结果黄斑区以中心凹1mm为直径视网膜厚度正常组、NDR组、NPDR组、PDR组分别为(246.37±17.50)μm、(252.13±16.24)μm、(316.28±56.99)μm、(407.90±214.89)μm。4组黄斑区平均视网膜厚度分别为(285.07±10.42)μm、(289.45±11.19)μm、(332.31±39.71)μm、(390.20±64.17)μm;总体积分别为(10.22±0.39)mm3、(10.12±1.03)mm3、(11.99±3.29)mm3、(13.87±5.13)mm3。与正常组相比,NPDR、PDR组黄斑部A1-A9区视网膜厚度、黄斑部平均视网膜厚度、黄斑部总体积差异均有统计学意义(均为P<0.05);NDR组与正常组相比,A1-A9区视网膜厚度、黄斑部平均视网膜厚度、黄斑部总体积差异均无统计学意义(均为P>0.05);NDR、NPDR、PDR3组间以上各指标两两比较差异均有统计学意义(均为P<0.05)。结论黄斑区视网膜厚度及体积与DR程度相关。频域OCT能定量定性地观察糖尿病患者黄斑区的细微变化,为糖尿病患者黄斑病变早期诊断及治疗提供可靠的检测手段。     

Evaluation of successful macular hole surgery by optical coherence tomography and multifocal electroretinography

PURPOSE: To evaluate successful macular hole surgery using optical coherence tomography (OCT) and multifocal electroretinography (MFERG). DESIGN: Interventional case series. METHODS: In a prospective study, 20 eyes of 20 patients with successful surgery for stage II, III, or IV idiopathic macular hole were evaluated by best-corrected visual acuity (BCVA), ocular examination, OCT, and MFERG preoperatively and 1, 3, 6, and 12 months postoperatively. For statistical analysis, the paired t test and nonparametric methods were used, as well as the Spearman analysis. RESULTS: Postoperatively, all 20 eyes of 20 patients had anatomic closure of the macular hole confirmed by OCT. The center of the fovea, measured by OCT from the retinal pigment epithelium to the inner retinal surface, had a mean +/- SD thickness of 116.5 +/- 30.9 microm (range, 68-175 microm) 1 year postoperatively. Best-corrected visual acuity significantly improved (preoperative mean +/- standard deviation [SD] value, 0.131 +/- 0.081 and 1 year postoperative mean +/- SD value, 0.407 +/- 0.193). Multifocal electroretinography values area 1 (0-2.8 degrees) and area 2 (2.8-9 degrees from the center of the fovea) significantly improved (preoperative mean +/- SD values 3.10 +/- 1.334 nV/deg(2) and 3.573 +/- 1.545 nV/deg(2), respectively, and 1 year postoperative +/- SD mean values, 5.53 +/- 1.208 nV/deg(2) and 4.748 +/- 1.404 nV/deg(2), respectively). The thickness of the fovea, measured by OCT, significantly correlated with the BCVA 1 year postoperatively. One year postoperative MFERG values areas 1 and 2 were not correlated with 12-month BCVA and OCT findings. CONCLUSIONS: Twelve months postoperatively BCVA and MFERG values significantly improved in this series of eyes with successful macular hole surgery. Optical coherence tomography findings were correlated to BCVA, but MFERG values were not correlated to BCVA and OCT findings, 1 year postoperatively.     

Comparison of foveal thickness measured with the retinal thickness analyzer and optical coherence tomography.

PURPOSE: To assess and compare the reliability and reproducibility of retinal thickness measurements for the retinal thickness analyzer (RTA) and optical coherence tomography (OCT) in normal and edematous retina. METHODS: The authors measured the foveal thickness of 21 normal eyes and 9 eyes with macular edema with both methods in random order. With the RTA, the fovea was measured 10 times; with the OCT, six scans (one horizontal and five vertical cross-sections) of the fovea were obtained. RESULTS: Mean foveal thickness of normal eyes measured 153 microm with OCT and 181 microm with RTA (median for both methods 150 microm). Coefficients of variation (CV) within the same subjects were 10% (OCT) and 9% (RTA) reducing to 9% (OCT) and 7% (RTA) when scans were repeated only five times for both methods. The RTA, however, yielded an interpatient CV of 33% (OCT 17%), which was caused by several falsely high readings in normal individuals. In eyes with retinal thickening the OCT measured a mean of 324 microm with 15% intra- and 58% interpatient CV. The RTA yielded a mean of 403 microm with CV of 18% and 73%, respectively. CONCLUSION: Both methods yield reproducible measurements of foveal thickness in normal individuals and individuals with macular edema. However, falsely high measurements may occur with the RTA, reducing its reliability as compared to the OCT.     

累及黄斑的孔源性视网膜脱离手术前后黄斑区光学相干断层扫描与多焦视网膜电图的变化

目的：观察累及黄斑区的孔源性视网膜脱离( RRD)患眼手术前后黄斑区光学相干断层扫描(OCT)与多焦视网膜电图（mfERG）表现的变化。 方法：回顾性研究。选择2013年9月至2014年7月在河南省眼科研究所确诊为累及黄斑的RRD并行巩膜扣带术的患者52例（52眼）,以对侧正常眼作对照。RRD患眼均行巩膜扣带手术治疗。手术前及手术后1周,术后1、3、6个月,进行OCT及mfERG检查,观察RRD患眼黄斑区微结构,以及黄斑区反应振幅密度及潜伏期的变化。采用t检验对术前患眼与正常眼进行比较,采用重复测景方差分析对患眼手术前后黄斑中心凹厚度变化与中央1环的N1、P1波反应密度和潜伏期比较分析;采用Pearson积矩相关分析法分析术后各时问点最佳矫正视力(BCVA)与黄斑中心凹厚度、中央1环的N1、P1波反应密度和潜伏期的相关性。 结果：所有患眼术后均成功复位。术前患眼黄斑中心凹厚度较正常眼明显增厚,为(534+44) μm,差异有统计学意义（t=17.127,P<0.05）,术后1周、1个月、3个月、6个月患者黄斑中心凹厚度,较术前明显降低,差异有统计学意义(P<0.01)。与正常眼相比较,术前患者中央1环Nl波和P1波振幅密度降低（t_N1=17.372、t_p1=23.943,P< 0.05）,潜伏期延长（t_Nl=5.291、t_Pl=7.306,P< 0.05）,差异均有统计学意义,术后1周、术后1、3、6个月中央1环N1波及P1波振幅密度较术前均提高（P<0.01）,潜伏期与术前差异无统计学意义。患者BCVA在术后1、3、6个月与黄斑中心凹厚度呈负相关(r=-0.801、-0.695、-0.643,P<0.05),l与中央1环N1波及P1波振幅密度呈正相关(r_N1=0.702、0.695、0.632,r_p1=0.811、0.713、0.648;P< 0.05),与潜伏期无相关性。 结论：OCT与mfERG可以客观综合观察RRD患者术后黄斑区的形态和功能,评估视网膜脱离后的手术疗效。     

高度近视眼黄斑部视网膜神经上皮层厚度的分区测量研究

目的:研究高度近视眼黄斑部各区域视网膜神经上皮层厚度的分布特点,并分析其与性别、年龄、眼压、等效球镜度数和眼轴长度之间的相关性。方法:除眼底视盘旁近视弧外无其他眼部异常和眼底病变的高度近视患者102例,随机选取每例患者1眼受检。所有受检眼均予眼压、屈光检查、眼轴长度测定、9个区域的黄斑视网膜神经上皮层平均厚度和黄斑中心凹视网膜厚度最小值测定。将黄斑部各区域视网膜神经上皮层平均厚度和黄斑中心凹视网膜厚度最小值与性别、年龄、眼压、等效球镜度数及眼轴长度进行相关性分析和偏相关分析。各区黄斑视网膜神经上皮层平均厚度和黄斑中心凹视网膜厚度最小值进行多配对样本的Friedman检验。结果:本组受检者黄斑中心凹视网膜厚度最小值为175.34±29.01μm。各区黄斑视网膜神经上皮层平均厚度分布存在显著差异:内环区视网膜神经上皮层厚度较外环区厚;鼻侧和上下方视网膜神经上皮层较厚,颞侧较薄;中央区和中心小凹最薄。随着眼轴的延长,中央区视网膜神经上皮层厚度增厚,外环区上方视网膜神经上皮层变薄。结论:眼轴长度增加所致的黄斑视网膜神经上皮层厚度改变可能是高度近视黄斑变性发生发展的病理基础。