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)

Optical coherence tomography of idiopathic macular epiretinal membranes

Objective 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 Total of 67 cases (73 eyes) with clinical diagnosis of IMEM by direct, indirect ophthalmoscopy, three mirror contact lens, fundus color photography or fundus 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 with macular pseudoholes in 14 eyes and ERMs with laminar macular holes in 7 eyes. Based on OCT, the ERMs were clearly and partially seperated from the retina (27 eyes, 38.36%), the retinal thickness of the fovea was the thickest in proliferative ERMs and the thinnest in 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 image 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 visual acnity in the affected eyes with ERMs.