频域OCT检查对黄斑水肿特点的分析

目的 通过频域OCT对黄斑水肿形态进行观察,了解水肿程度及分布情况,并分析水肿与视力的相关性.方法 选取患黄斑水肿患者25例29只眼,病例包括视网膜中央静脉阻塞所致为8例8只眼,视网膜分支静脉阻塞7例7只眼,葡萄膜炎4例4只眼,糖尿病性视网膜病变6例10只眼.年龄52-83(64.76±8.30)岁.最佳矫正视力(BCVA)0.05～1.0(0.35±0.12).利用最新一代频域RTVueFD-OCT对黄斑区进行扫描.结果 黄斑区15°范围内神经上皮厚度(453.00±103.12)μm,其中各区域神经上皮层厚度为:中心凹(533.10±115.23)μm,旁中心区(488.93±89.71)μm,中心凹边缘区(397.05±83.52)μm.不同区域神经上皮层厚度比较差异有统计学意义(F=2.937,P<0.01),黄斑区中心凹区神经上皮层厚度与中心凹边缘区神经上皮层厚度比较差异有统计学意义(与上、下、鼻、颞侧比较结果P<0.01,以中心凹区最厚,依次为下、上、颞、鼻侧边缘区).而中心凹神经上皮层厚度与旁中心凹区神经上皮层厚度比较差异无统计学意义与上、下、鼻、颞侧比较结果P>0.05.患者BCVA与中心凹神经上皮层厚度间存在负相关关系(r=-0.784,P<0.01),与旁中心凹区神经上皮层厚度间无相关关系(r=-0.134,P>0.05),与中心凹边缘区神经上皮层厚度间无相关关系(r=.275,P>0.05).结论 频域OCT能够精确地对黄斑水肿进行活体组织学成像,具有简便、非侵入性、重复性好等特点.

Analysis of macular edema characteristics with the spectral domain optical coherence tomography

Objective To find out the degree and distribufion of macular edema and analyze the corelation between macular edema and visual acuity by observing morphology of maeular edema under the spectral domain OCT.Methods Selecting 29 eyes of 25 cases suffered from macular edema.including 8 eyes of 8 cases with central retinal vein occlusion,7 eyes of 7 cases with branch retinal vein occlusion.4 eyes of 4 cases with uveitis,and 10 eyes of 6 cases with diabetic retinopathy.Age was 52～85(average 64.76±8.30),best corrected visual acuity (BCVA) was 0.05～1.0 (average0.35±0.12).Scanning macular with the newest spectral domain RTVue FD-OCT.Results In 15°macular afea,the thickness of neuro-epithelium layers were(453.00±103.12)μ m,thickness of various sectiolls Were:fovea (533.10±115.23)μ m,parafovea (488.93±89.71)μm,perifovea(397.05～83.52)μ m.There was statistically significant difference of neuroep. Ithelium layers thickness in various areas (F=2.937,P<0.01).There was statistically statisticany significant difference of neuroepithelium layers thickness between fovea and perifovea area (when compared to superior, inferior,nasal and temporal area,results were P=0.008,P=0.004,P=0.003,P<0.01 respectively).the foveaarea was the most thick,in turn were inferior,superior,temporal and nasal perifovea area.Moreover.there was no statistically significant difference of neuroepithelium layers thickness between the fovea area and parafovea area (when compared to superior,inferior,nasal and tempoml area,results were P=0.173,P>0.05).There was negative correlation between BCVA and fovea neuroepithelium layers thickness(r=-0.784, P=0.003),no correlation between BCVA and parafovea neuroepithelium layers thickness(r=-0.134.P> 0.05),and no correlation bctwceen BCVA and perifovea neuroepithelium layers thickness(r=0.275,P>0.05).Conclusions Spectral domain OCT could preciously display micmbiopsy image of macular edema,and let us furthe recognize the location and degree of macular edema,which has chatactcfistics of convenience.nonin-vasion，good reproducibility,and take on higher valuesin clinical application and popularization.