外伤性黄斑病变的OCT特征研究

目的研究外伤性黄斑病变的相干光断层扫描（OCT）图像特征，以总结其患病规律。设计回顾性病例系列。研究对象477例（486眼）4-76岁的外伤性黄斑病变患者。方法回顾及分析2002年9月．2009年6月在北京同仁医院眼科门诊就诊的不同类型外伤性黄斑病变患者的门诊病历资料及OCT图像。主要指标OCT图像特征。结果外伤性黄斑病变的OCT表现主要有九种：黄斑裂孔、神经上皮层脱离、黄斑出血、黄斑水肿、黄斑前膜、脉络膜破裂、黄斑部神经上皮层萎缩薄变、色素上皮层萎缩及脉络膜萎缩。在外伤的早期，较常见的OCT表现为黄斑部色素上皮层萎缩（49．0％）、黄斑裂孔（24．7％）、神经上皮层脱离（26．3％）、黄斑出血（24．2％）、黄斑水肿（19．2％）；在外伤的中晚期，较常见的OCT表现为黄斑部色素上皮层萎缩（63．0％）、神经上皮层萎缩薄变（36．5％）。结论外伤性黄斑病变以多种OCT表现并存为多，黄斑部视网膜色素上皮层萎缩是贯穿外伤早期、中晚期最多的表现。外伤性黄斑病变早期以黄斑裂孔、视网膜脱离、黄斑出血、黄斑水肿为主，中晚期以黄斑部神经上皮层及色素上皮层萎缩为主。（眼科，2009，18：236-238）

The image features of optical coherence tomography in traumatic maculopathy

Objective To investigate the optical coherence tomography (OCT) characteristics of traumatic maculopathy. Design Retrospective case series. Participants 477 patients (486 eyes) with traumatic maculopathy, who aged from 4 years to 76 years. Method The clinical and OCT data of patients from September 2002 to June 2009 in Beijing Tongren Hospital were reviewed. Main outcome measures Features of the OCT images. Results The major findings by OCT in traumatic maculopathy included: macular hole, sensory retinal detachment, macular hemorrhage, epimacular membrane, choroidal rupture, sensory retinal atrophy, retinal pigment ep-ithelium (RPE) and choroid atrophy. In the early stage after trauma, the common findings with OCT are atrophy of RPE(49.0%), macular hole(24.7%), sensory retinal detachment(26.3%),macular hemorrhage(24.2%) and macular edema(19.2%); in the middle-late stage, atro-phy of RPE (63.0%)and atrophy of sensory retina (36.5%) are the most common changes revealed with OCT. Conclusions OCT is a useful diagnostic modality for imaging traumatic maculopathy. Diverse changes of retina and choroid are usually coexisting by OCT. At-rophy of RPE is the most common change throughout the course. In the early stage, macular hole, sensory retinal detachment, macular hemorrhage and edema are the common changes. In the middle-late stage, atrophy of sensory retina and/or RPE is the dominating change. (Ophthalmol CHN, 2009, 18: 236-238)