特发性黄斑前膜的频域光相干断层扫描特征以及与视力的相互关系

Objective To observe the Fourier-domain optical coherence tomography(FD-OCT) characteristic of idiopathic epiretinal membrane (ERM) and its correlation with the patients visual acuity. Methods The 116 eyes (112 patients) with idiopathic epiretinal membrane were included in this study. All the patients had undergone examination of visual acuity (LogMAR chart), ocular fundus (direct ophthalmoscope and fundus pre-set lens), and FD-OCT (Zeiss HD-OCT) with the speed of 27 000 A scan/s, area of 6.0 mm× 6.0 mm, and mode of 512 × 128. The central fovea thickness (CFT), volume (V), average thickness (AT) were collected from the OCT readings, and the fovea thickness (FT) was measured manually. Data were analyzed using SPSS 16.0. Results The traction on retina caused by ERM can be divided into 3 types according to the OCT findings., no traction (9.48 %), tangential traction (84.48 %) and tangential traction with anterior-posterior traction (6.04 %). A total of 97 eyes (83.62 %) had retinal edema (diffuse or cystoid) and the edema located at the outer nuclear layer(ONL), outer plexiform layer(OPL)and inner nuclear layer (INL). A total of 14 eyes (12. 07%) had retinal nerve fiber layer (RNFL) schisis and 27 eyes (23.28%) had inner segment/outer segment j unction(Ls/OS) impairment. Statistic analysis revealed that BCVA was not related to the age, gender, types of traction, presence of IS/OS damage or RNFL schisis(P>0.05), but was related with CFT(P<0.05). Conclusions Idiopathic ERM can exert different types of traction on the macular, and cause different types of retinal lesions. OCT is a useful tool to measure these lesions. CFT reading is closely related to patients" visual acuity.     

高度近视眼底后部血管弓旁视网膜改变的频域光学相干断层扫描特征

目的通过频域光学相干断层扫描仪（OCT）观察高度近视眼底后部血管弓旁视网膜的形态改变并探讨相关因素。方法横断面研究。177例双眼高度近视患者（屈光不正≥－8 D或眼轴 ＞26.5 mm）,随机选择其中一只眼采用频域OCT观察后部血管弓旁视网膜形态。以高度近视伴血管弓旁视网膜改变为阳性组,高度近视不伴血管弓旁视网膜改变为阴性组,比较2组患者年龄、患眼屈光度以及眼轴长度的差异行独立样本t检验,2组患者后巩膜葡萄肿例数的差异行卡方检验。结果经频域OCT扫描证实,108例患者（61.0%）存在后部血管弓旁视网膜形态改变,平均年龄（59.3±6.2）岁。108只患眼等效球镜度（-13.55±3.43）D,眼轴长度（29.57±2.06）mm。阴性组69例（39.0%）患者平均年龄（34.8±13.1）岁,等效球镜度（-9.50±3.07）D,眼轴长度（27.02±1.02）mm。2组患者年龄（t=10.466,P<0.05）、等效屈光度（t=7.454,P<0.05）以及眼轴长度（t=10.979,P<0.05）差异均有统计学意义。在阳性组中,108例患者（100.0%）伴有血管弓旁视网膜微囊肿和微皱褶,65例（60.2%）伴有视网膜板层裂隙或裂孔,53例（49.1%）伴有视网膜不同层次的劈裂,1例（0.9%）伴有牵引性视网膜脱离。所有视网膜形态改变集中分布于距离视盘2～3 PD的后巩膜葡萄肿凹陷区内。阳性组101眼伴有后巩膜葡萄肿,阴性组48眼伴有后巩膜葡萄肿,2组差异具有统计学意义（x²=16.999,P<0.05）。结论高度近视眼后部血管弓旁视网膜常见一系列细微的形态改变,玻璃体皮质牵引和后巩膜葡萄肿的发展应是其形成的重要原因。     

特发性黄斑前膜的频域光相干断层扫描特征以及与视力的相互关系

目的 观察特发性黄斑前膜的光相干断层扫描（OCT）特征以及与患者视力的相互关系。方法 回顾分析2008年5月至12月间确诊的特发性黄斑前膜患者112例116只眼的临床资料。所有患者均进行最佳矫正视力、眼底和OCT检查。视力采用LogMAR视力表检查;眼底检查采用直接检眼镜和前置镜检查;OCT检查采用Zeiss HD-OCT,扫描速度27 000 A扫描/s, 扫描区域6.0 mm×6.0 mm,扫描模式为512×128。根据OCT检查所见的黄斑前膜对视网膜不同牵引情况对黄斑前膜进行分类,测量黄斑中心厚度（CFT）、体积、平均厚度以及黄斑中心凹厚度（FT）。采用SPSS16.0软件对患者的各项OCT检查指标和临床检查结果进行统计分析。结果 116只黄斑前膜眼可分为无视网膜牵引、切线方向或切线方向合并前后方向牵引3种情况,各自分别占本组患眼的9.48%、84.48%、6.04%。97只眼合并视网膜水肿,占总眼数的83.62%;水肿分别位于外核层(ONL),外网状层(OPL),内核层(INL)。14只眼合并视网膜神经纤维层(RNFL)劈裂,占总眼数的1207%;27只眼有视细胞内外节（IS/OS）损伤,占总眼数的23.28%。CFT与视力密切相关（P<0.05）,而体积、平均厚度和FT与视力无相关性（P＞0.05）。患者年龄、性别、不同种类的视网膜牵引、是否合并板层孔、IS/OS损伤和RNFL劈裂等与视力无相关性。结论 特发性黄斑前膜的OCT特征可表现为有无视网膜牵引以及视网膜水肿和视网膜神经纤维层劈裂。在CFT、体积、平均厚度以及FT等黄斑区OCT测量指标中,CFT与患者的视力关系最为密切。     

特发性黄斑前膜的频域光相干断层扫描特征以及与视力的相互关系

Objective To observe the Fourier-domain optical coherence tomography(FD-OCT) characteristic of idiopathic epiretinal membrane (ERM) and its correlation with the patients visual acuity. Methods The 116 eyes (112 patients) with idiopathic epiretinal membrane were included in this study. All the patients had undergone examination of visual acuity (LogMAR chart), ocular fundus (direct ophthalmoscope and fundus pre-set lens), and FD-OCT (Zeiss HD-OCT) with the speed of 27 000 A scan/s, area of 6.0 mm× 6.0 mm, and mode of 512 × 128. The central fovea thickness (CFT), volume (V), average thickness (AT) were collected from the OCT readings, and the fovea thickness (FT) was measured manually. Data were analyzed using SPSS 16.0. Results The traction on retina caused by ERM can be divided into 3 types according to the OCT findings., no traction (9.48 %), tangential traction (84.48 %) and tangential traction with anterior-posterior traction (6.04 %). A total of 97 eyes (83.62 %) had retinal edema (diffuse or cystoid) and the edema located at the outer nuclear layer(ONL), outer plexiform layer(OPL)and inner nuclear layer (INL). A total of 14 eyes (12. 07%) had retinal nerve fiber layer (RNFL) schisis and 27 eyes (23.28%) had inner segment/outer segment j unction(Ls/OS) impairment. Statistic analysis revealed that BCVA was not related to the age, gender, types of traction, presence of IS/OS damage or RNFL schisis(P>0.05), but was related with CFT(P<0.05). Conclusions Idiopathic ERM can exert different types of traction on the macular, and cause different types of retinal lesions. OCT is a useful tool to measure these lesions. CFT reading is closely related to patients" visual acuity.     

特发性黄斑前膜的频域光相干断层扫描特征以及与视力的相互关系

Objective To observe the Fourier-domain optical coherence tomography(FD-OCT) characteristic of idiopathic epiretinal membrane (ERM) and its correlation with the patients visual acuity. Methods The 116 eyes (112 patients) with idiopathic epiretinal membrane were included in this study. All the patients had undergone examination of visual acuity (LogMAR chart), ocular fundus (direct ophthalmoscope and fundus pre-set lens), and FD-OCT (Zeiss HD-OCT) with the speed of 27 000 A scan/s, area of 6.0 mm× 6.0 mm, and mode of 512 × 128. The central fovea thickness (CFT), volume (V), average thickness (AT) were collected from the OCT readings, and the fovea thickness (FT) was measured manually. Data were analyzed using SPSS 16.0. Results The traction on retina caused by ERM can be divided into 3 types according to the OCT findings., no traction (9.48 %), tangential traction (84.48 %) and tangential traction with anterior-posterior traction (6.04 %). A total of 97 eyes (83.62 %) had retinal edema (diffuse or cystoid) and the edema located at the outer nuclear layer(ONL), outer plexiform layer(OPL)and inner nuclear layer (INL). A total of 14 eyes (12. 07%) had retinal nerve fiber layer (RNFL) schisis and 27 eyes (23.28%) had inner segment/outer segment j unction(Ls/OS) impairment. Statistic analysis revealed that BCVA was not related to the age, gender, types of traction, presence of IS/OS damage or RNFL schisis(P>0.05), but was related with CFT(P<0.05). Conclusions Idiopathic ERM can exert different types of traction on the macular, and cause different types of retinal lesions. OCT is a useful tool to measure these lesions. CFT reading is closely related to patients" visual acuity.     

特发性黄斑前膜的频域光相干断层扫描特征以及与视力的相互关系

Objective To observe the Fourier-domain optical coherence tomography(FD-OCT) characteristic of idiopathic epiretinal membrane (ERM) and its correlation with the patients visual acuity. Methods The 116 eyes (112 patients) with idiopathic epiretinal membrane were included in this study. All the patients had undergone examination of visual acuity (LogMAR chart), ocular fundus (direct ophthalmoscope and fundus pre-set lens), and FD-OCT (Zeiss HD-OCT) with the speed of 27 000 A scan/s, area of 6.0 mm× 6.0 mm, and mode of 512 × 128. The central fovea thickness (CFT), volume (V), average thickness (AT) were collected from the OCT readings, and the fovea thickness (FT) was measured manually. Data were analyzed using SPSS 16.0. Results The traction on retina caused by ERM can be divided into 3 types according to the OCT findings., no traction (9.48 %), tangential traction (84.48 %) and tangential traction with anterior-posterior traction (6.04 %). A total of 97 eyes (83.62 %) had retinal edema (diffuse or cystoid) and the edema located at the outer nuclear layer(ONL), outer plexiform layer(OPL)and inner nuclear layer (INL). A total of 14 eyes (12. 07%) had retinal nerve fiber layer (RNFL) schisis and 27 eyes (23.28%) had inner segment/outer segment j unction(Ls/OS) impairment. Statistic analysis revealed that BCVA was not related to the age, gender, types of traction, presence of IS/OS damage or RNFL schisis(P>0.05), but was related with CFT(P<0.05). Conclusions Idiopathic ERM can exert different types of traction on the macular, and cause different types of retinal lesions. OCT is a useful tool to measure these lesions. CFT reading is closely related to patients" visual acuity.     

急性期Vogt-Koyanagi-Harada综合征患眼治疗前后频域光相干断层扫描图像特征

[目的]观察急性期Vogt-Koyanagi-Harada(VKH)综合征患眼治疗前后的频域光相干断层扫描(OCT)图像特征.[方法]经裂隙灯显微镜、B型超声及荧光素眼底血管造影(FFA)检查确诊为急性期VKH综合征的28例患者56只眼纳入研究.所有患者确诊后均接受糖皮质激素冲击治疗;治疗前后均行频域OCT检查.治疗后随访观察12～32周,平均随访时间(21.30±8.53)周.对比分析治疗前后OCT检查所见的中心凹视网膜脱离高度、光感受器细胞内外节连接(IS/OS)光带及血管弓内视网膜结构的变化情况.[结果]治疗前OCT检查结果显示,所有患眼均存在神经上皮脱离,中心凹处平均神经上皮脱离高度为(635.44±340.04)μm.视网膜下腔中有各类渗出性改变43只眼,占76.8％;伴点状中强反射41只眼,占73.2％;旁中心凹部分节段外核层增厚呈“指状”突起与膜样结构相连22只眼,占39.3％;视网膜色素上皮(RPE)光带呈波浪状33只眼,占58.9％.治疗后不同观察时间的OCT检查结果显示,1周内所有患眼神经上皮下腔膜样结构及无定形中弱反射消失,同时可见RPE表面大量中强反射颗粒,RPE光带恢复平滑.治疗后平均(2.33±0.82)周时,所有患眼后极部神经上皮下积液完全吸收,黄斑复位,中心凹下IS/OS光带恢复连续,中心凹周围IS/OS光带和外界膜不连续.治疗后平均(5.01±6.71)周时,所有患眼整个水平扫描线上外界膜恢复连续,IS/OS光带恢复区域逐渐扩大.治疗后平均(11.40±7.89)周时,整个水平扫描线上IS/OS光带恢复连续45只眼,占80.4％;IS/OS光带仍有部分缺损11只眼,占19.6％.整个后极部扫描区域内IS/OS光带仍有缺损46只眼,占82.1％整个后极部扫描区域内IS/OS光带完整10只眼,占17.9％.有区域性外核层变薄,且在这些区域视网膜外层的外界膜和IS/OS光带缺失11只眼,占19.6％.[结论]急性期VKH综合征患眼OCT检查图像特征为,治疗前存在神经上皮脱离,脱离下腔可有多种类型的渗出性改变,RPE光带呈波浪状;治疗后渗出性改变迅速溶解,但视网膜下腔的中强反射颗粒仍然存在,RPE光带恢复平滑,且外界膜连续性的恢复早于IS/OS光带.     

18例急性区域性隐匿性外层视网膜病变的临床分析

[目的]观察急性区域性隐匿性外层视网膜病变(AZOOR)的临床特征.[方法]临床确诊为AZOOR的18例患者18只眼纳入研究.所有患者均行矫正视力、眼底、视野、视网膜电图(ERG)检查.部分患者同时行荧光素眼底血管造影(FFA)、光相干断层扫描(OCT)、视觉诱发电位(VEP)及多焦视网膜电图(mf-ERG)检查.观察患者的临床特征.对比分析患眼与对侧眼的视觉电生理检查结果.分析同时行OCT、视野和mf-ERG检查者的检测结果一致性.[结果]患者中,男性3例,女性15例;均为单眼发病.其中,正视2只眼,占l1.1％;近视16只眼,占88.9％.无明显眼底改变11只眼,占61.1％;黄斑区附近单发黄白色点状病灶或视网膜色素上皮改变3只眼,占16.7％;颞侧呈区域性脱色素改变4只眼,占22.2％.所有息眼中心视野异常,周边视野正常.行OCT检查的患眼均存在不同程度光感受器细胞内外节连接(IS/OS)光带中断、缺失或毛糙.ERG检查发现,与对侧眼比较,患眼视杆反应b波,最大反应a/b波,视锥反应a、b波及30 Hz闪烁光反应振幅均降低,差异有统计学意义(t=3.516,2.689,3.103,3.517,2.999,3.309;P＜0.05);除视杆反应b波潜伏期差异无统计学意义外(t=1.023,P=0.306),其余波潜伏期均较对侧眼延长,差异有统计学意义(P＜0.05).VEP检查发现,患眼P100波振幅较对侧眼降低,差异有统计学意义(t=2.040,P=0.041);患眼与对侧眼P100波潜伏期比较,差异无统计学意义(t=1.687,P=0.092).行mf-ERG检查的患眼均存在振幅改变.OCT与mf-ERG检测结果具有良好的一致性;而中心视野与mf-ERG检测结果不完全一致,其异常区域分布不相吻合.[结论]AZOOR以青年女性、近视眼发病为多见;通常无明显眼底改变;但中心视野及视觉电生理检查存在异常,OCT检查可见其存在不同程度的IS/OS光带中断、缺失或毛糙.     

特发性黄斑前膜的频域光相干断层扫描特征以及与视力的相互关系

Objective To observe the Fourier-domain optical coherence tomography(FD-OCT) characteristic of idiopathic epiretinal membrane (ERM) and its correlation with the patients visual acuity. Methods The 116 eyes (112 patients) with idiopathic epiretinal membrane were included in this study. All the patients had undergone examination of visual acuity (LogMAR chart), ocular fundus (direct ophthalmoscope and fundus pre-set lens), and FD-OCT (Zeiss HD-OCT) with the speed of 27 000 A scan/s, area of 6.0 mm× 6.0 mm, and mode of 512 × 128. The central fovea thickness (CFT), volume (V), average thickness (AT) were collected from the OCT readings, and the fovea thickness (FT) was measured manually. Data were analyzed using SPSS 16.0. Results The traction on retina caused by ERM can be divided into 3 types according to the OCT findings., no traction (9.48 %), tangential traction (84.48 %) and tangential traction with anterior-posterior traction (6.04 %). A total of 97 eyes (83.62 %) had retinal edema (diffuse or cystoid) and the edema located at the outer nuclear layer(ONL), outer plexiform layer(OPL)and inner nuclear layer (INL). A total of 14 eyes (12. 07%) had retinal nerve fiber layer (RNFL) schisis and 27 eyes (23.28%) had inner segment/outer segment j unction(Ls/OS) impairment. Statistic analysis revealed that BCVA was not related to the age, gender, types of traction, presence of IS/OS damage or RNFL schisis(P>0.05), but was related with CFT(P<0.05). Conclusions Idiopathic ERM can exert different types of traction on the macular, and cause different types of retinal lesions. OCT is a useful tool to measure these lesions. CFT reading is closely related to patients" visual acuity.