CAJ | 학술논문

目的观察外伤性黄斑裂孔的光相干断层扫描(OCT)形态特征及其临床意义.方法对采用国际标准视力表、裂隙灯显微镜、直接或间接检眼镜、三面镜检查确诊的74例闭合性眼外伤致黄斑裂孔患者74只眼进行光相干断层扫描(OCT)检查.利用OCT分析软件对外伤性黄斑裂孔进行定量测量,并根据OCT图像特征对外伤性黄斑裂孔进行分型.OCT检查完毕用Topcon眼底照相机进行眼底50.彩色照相.回顾分析患者黄斑裂孔与平均视力、病程、孔缘神经上皮层厚度、裂孔底径、孔径之间的相互关系.结果 74只眼的OCT图像特征可分为5种类型.其中,黄斑裂孔伴神经上皮层对称性水肿27只眼,占36.5%;黄斑裂孔伴神经上皮层不对称性水肿12只眼,占16.2%;单纯性黄斑裂孔14只眼占18.9%;黄斑裂孔伴神经上皮层局限性脱离17只眼,占23.0%;黄斑裂孔伴神经上皮层变薄4只眼,占5.4%.不同类型的黄斑裂孔之间视力比较,差异无统计学意义(F=1.574,P=0.191);其视力与孔缘平均神经上皮层厚度晕正相关(r=0.342,P=0.003),与致伤时间、年龄、裂孔直径无明显相关关系(r=-0.022～-0.134,P=0.863～0.261).黄斑裂孔伴神经上皮层局限脱离者,病程较其它各型黄斑裂孔者病程短;病程90 d及以上的患者中,黄斑裂孔伴神经上皮层对称性水肿最多.各型黄斑裂孔的孔缘神经上皮层厚度之间比较,差异有统计学意义(F=13.921,P=0.000).结论外伤性黄斑裂孔可根据OCT形态特征分为5种类型,不同类型的外伤性黄斑裂孔临床特征存在差异.
목적 관찰외상성황반렬공적광상간단층소묘(OCT)형태특정급기림상의의.방법대채용국제표준시력표、렬극등현미경、직접혹간접검안경、삼면경검사학진적74례폐합성안외상치황반렬공환자74지안진행광상간단층소묘(OCT)검사.이용OCT분석연건대외상성황반렬공진행정량측량,병근거OCT도상특정대외상성황반렬공진행분형.OCT검사완필용Topcon안저조상궤진행안저50.채색조상.회고분석환자황반렬공여평균시력、병정、공연신경상피층후도、렬공저경、공경지간적상호관계.결과 74지안적OCT도상특정가분위5충류형.기중,황반렬공반신경상피층대칭성수종27지안,점36.5%;황반렬공반신경상피층불대칭성수종12지안,점16.2%;단순성황반렬공14지안점18.9%;황반렬공반신경상피층국한성탈리17지안,점23.0%;황반렬공반신경상피층변박4지안,점5.4%.불동류형적황반렬공지간시력비교,차이무통계학의의(F=1.574,P=0.191);기시력여공연평균신경상피층후도훈정상관(r=0.342,P=0.003),여치상시간、년령、렬공직경무명현상관관계(r=-0.022～-0.134,P=0.863～0.261).황반렬공반신경상피층국한탈리자,병정교기타각형황반렬공자병정단;병정90 d급이상적환자중,황반렬공반신경상피층대칭성수종최다.각형황반렬공적공연신경상피층후도지간비교,차이유통계학의의(F=13.921,P=0.000).결론 외상성황반렬공가근거OCT형태특정분위5충류형,불동류형적외상성황반렬공림상특정존재차이.
Objective To observe the features of the images of optical coherence tomograpy (OCT) in patients with traumatic macular hole (TMH), and detect the clinical significance of OCT. Methods Consecutive 74 patients (74 eyes) diagnosed with TMH by examinations of visual acuity, slit lamp, and direct or indirect ophthalmoscopy underwent optical coherence tomography (OCT), The analysis software of OCT was used to make the quantitative measurements of TMH. And the TMH were classified according to the morphological characteristics of the images of OCT. 50°color fundus photography was performed on the patients after OCT. The relationship of TMH with the average visual acuity, disease duration, average neuroepithelial thickness on the margin of hole, and the base diameter and the apex diameter of macular hole were retrospectively analyzed. Results The characterisctics of the images of 74 cases (74 eyes) of TMH were classified into 5 types: macular holes with symmetric edema of the neurosensory retina at the margin in 27 eyes (36.5%), macular holes with asymmetric edema of the neurosensory retina at the margin in 12 eyes (16.2%), macular hole with full-thickness defect of neurosensory retina without edema or detachment at the margin in 14 eyes (18.9 %), macular hole with localized detachment of the neurosensory retina at the margin without edema in 17 eyes (23.0 %), and macular hole with thinning neurosensory retina in 4 eyes (5. 4 %).There was no significant difference of visual acuity among different types of TMH (F=1. 574, P=0. 191).The visual acuity was positively related with the marginal retinal thickness (r=0. 342, P=0. 003), but not related to age, diameter of macular hole or the disease duration(r value was from-0. 022 to-0. 134, P value was from 0. 863 to 0. 261). The disease duration of Type IV TMH was shorter than that of other TMH types. In the patients with the disease duration over 90 days, Type I TMH was predominant. The average retinal thicknesses at the margin of the hole showed significant differences among different TMH types (F= 13.921, P= 0.000). Conclusions TMH could be divided into 5 types according to the characteristics of images of OCT; the clinical characteristics of different types of TMH varies.