上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (6): 796-.doi: 10.3969/j.issn.1674-8115.2012.06.023

• 论著（临床研究） • 上一篇    下一篇

光学相干断层扫描在特发性黄斑前膜诊治中的应用价值

周正申, 孙静芬   

  1. 上海交通大学 医学院附属瑞金医院眼科, 上海 200025
  • 出版日期:2012-06-28 发布日期:2012-07-02
  • 通讯作者: 孙静芬, 电子信箱: sunjingfen@sohu.com。
  • 作者简介:周正申(1969—), 女, 副主任医师, 硕士；电子信箱: zzshen2007@yahoo.com.cn。

Clinical application of optical coherence tomography in idiopathic macular epiretinal membranes

ZHOU Zheng-shen, SUN Jing-fen   

  1. Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2012-06-28 Published:2012-07-02

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摘要：

目的 观察光学相干断层扫描(OCT)检查在特发性黄斑前膜（IMEM）诊治中的应用价值，分析OCT检查指标与患者视力的相关性。方法 回顾分析107例(121眼)IMEM患者的临床资料。根据OCT图像对黄斑前膜进行分类，测量黄斑中央中心凹厚度(CFT)、体积(V)、平均厚度(AT)以及黄斑中心凹厚度(FT)。分析OCT各项指标和临床检查结果与患者LogMAR最佳矫正视力的相关性。结果 IMEM的OCT图像表现为视网膜表面薄厚不一的、与视网膜呈紧密粘连或分离的高反光带，绝大多数伴有程度不同的中心凹水肿增厚。121眼平均LogMAR最佳矫正视力为0.67(0~2)，CFT为 (481.34±68.13) μm (206~572 μm)，FT为(311.57±124.76) μm(134~639 μm)。CFT与LogMAR最佳矫正视力密切相关(r=0.761, P<0.05)，而V、AT、FT与LogMAR最佳矫正视力无相关性；患者年龄、性别以及是否合并视网膜水肿、板层孔、视网膜神经纤维层劈裂及感光细胞内外节损伤与LogMAR最佳矫正视均无相关性。结论 OCT诊断IMEM具有较高的灵敏性，并可直观显示黄斑区视网膜组织结构的改变及其相互关系。IMEM引起的黄斑区水肿增厚与视力损害密切相关。

关键词: 光学相干断层扫描, 特发性黄斑前膜, 诊断方法

Abstract:

Objective To investigate the application of optical coherence tomography (OCT) in idiopathic macular epiretinal membranes (IMEM), and explore its correlation with visual acuity. Methods The clinical data of 107 patients (121 eyes) with IMEM were retrospectively analysed. Macular epiretinal membranes were classified according to OCT images, and macular central fovea thickness (CFT), volume (V), average thickness (AT) and fovea thickness (FT) were measured. The correlation of OCT parameters and clinical findings with best corrected visual acuity of LogMAR was analysed. Results IMEM were visible on OCT as high reflective tissues, which were thin or thick, and were separated from or nestled up against the retinal surface. In most fovea, the depth decreased and the thickness increased. The average best corrected visual acuity of LogMAR of 121 eyes was 0.67 (0 to 2), CFT was (481.34±68.13) μm (206-572 μm), and FT was (311.57±124.76) μm (134-639 μm). Statistic analysis revealed that the average best corrected visual acuity of LogMAR was significantly related to CFT (r=0.761, P<0.05), while was not related to age, gender, V, AT, FT, retinal edema, lamellar macular hole, retinal nerve fiber layer schisis and damage of inner segment/outer segment of photosensory cells. Conclusion OCT has a high sensitivity in clinical diagnosis of IMEM, and can objectively display the morphological change of macular tissues. Increased central fovea thickness caused by IMEM is closely related to the impairment of visual acuity.

Key words: optical coherence tomography, idiopathic macular epiretinal membranes, diagnostic method