光学相干断层扫描在Vogt-小柳-原田病诊疗中的应用

目的 观察和分析Vogt-小柳-原田病的光学相干断层扫描（optical coherence tomography,OCT）的典型图像特征.方法 对23例（46眼）Vogt-小柳-原田病急性期患者进行OCT和荧光素眼底血管造影（fundus fluorescein angiography,FFA）检查,并对所得到的图像进行分析.结果 治疗前,23例患者OCT均表现为后极部程度不等的神经上皮脱离,呈“拱桥样”高度隆起,通常被薄的间隔分成几部分,呈囊样或多囊样,黄斑中心凹视网膜平均厚度为（914.64±391.30） μm.口服糖皮质激素治疗后,视网膜下液逐渐吸收,神经上皮脱离范围和高度逐渐恢复正常,最终完全吸收,浆液性视网膜脱离消失,OCT恢复正常,黄斑中心凹视网膜平均厚度为（160.88±29.49） μm,与治疗前相比,差异有统计学意义（t=8.609,P＜O.01）.结论 Vogt-小柳-原田病OCT图像的特征性表现对于该病的早期诊断很有帮助,并能够直观地呈现其视网膜组织微细结构的改变,同时为疾病的病情追踪、疗效评价及视力预后判断提供了客观定量的评价标准。

An application of optical coherence tomography in the diagnosis and treatment of Vogt - Koyanagi - Harada disease

Objective To observe and analyze the characteristic image of optical coherence tomography （OCT） in patients with Vogt-Koyanagi-Harada （VKH） disease.Methods 46 eyes of 23 patients with VKH disease were examined with OCT and fundus fluorescein angiography （FFA）.Results All 46 eyes had the multiple retinal neurosensory detachment in the posterior pole,and subretinal septa that divided the subretinal space into several compartments.The average retinal thickness at foveal centralis was （914.64 ±391.30） μm.After the oral corticosteroids treatment,subretinal septa resolved,serous retinal detachment disappeared.The average retinal thickness at foveal centralis was （160.88 ± 29.49） μm,decreased significantly （t =8.609,P 〈 0.01）.Conclusion OCT can display the characteristics of VKH and directly detect the tinny structural changes occurred in the neuroretina.It is a useful method for the diagnosis of VKH and we could acknowledge the disease more completely and directly by OCT.