CAJ | 학술논문

目的观察葡萄膜炎患者黄斑水肿的光学相干断层扫描(OCT)图像特征及与临床的关联,探讨频域OCT在葡萄膜炎性黄斑水肿定性和定量分析中的应用价值.方法连续临床病例横断面研究.对河南省眼科研究所在2009年4月至2011年3月就诊的葡萄膜炎并黄斑水肿169只眼进行频域OCT检查,分析黄斑水肿的类型及各参数与视力的相关性,并与FFA结果对比分析.结果 (1)黄斑水肿分型:囊样水肿占43.19％,弥漫性水肿占34.91％,单纯神经上皮脱离占10.06％,11.83％同时出现3种改变；囊样水肿发生率最高.(2)光感受器内外节连接体断裂者54只眼(31.95％),玻璃体后脱离者33只眼(19.53％)；存在明显玻璃体视网膜牵拉者15只眼(8.88％),黄斑前膜者33只眼(19.53％).(3)囊样水肿组平均黄斑厚度高于弥漫性水肿组,两组视网膜厚度均与视力呈负相关；连接体断裂组视力较完整组低；存在黄斑前膜组视力较低.(4) OCT与FFA对黄斑水肿的检出一致率为86.39％.结论葡萄膜炎所导致的黄斑水肿其形态可表现为多种不同的类型,OCT可以对这些改变进行有效观察,其中有些改变与视力密切相关.
목적 관찰포도막염환자황반수종적광학상간단층소묘(OCT)도상특정급여림상적관련,탐토빈역OCT재포도막염성황반수종정성화정량분석중적응용개치.방법 련속림상병례횡단면연구.대하남성안과연구소재2009년4월지2011년3월취진적포도막염병황반수종169지안진행빈역OCT검사,분석황반수종적류형급각삼수여시력적상관성,병여FFA결과대비분석.결과 (1)황반수종분형:낭양수종점43.19％,미만성수종점34.91％,단순신경상피탈리점10.06％,11.83％동시출현3충개변；낭양수종발생솔최고.(2)광감수기내외절련접체단렬자54지안(31.95％),파리체후탈리자33지안(19.53％)；존재명현파리체시망막견랍자15지안(8.88％),황반전막자33지안(19.53％).(3)낭양수종조평균황반후도고우미만성수종조,량조시망막후도균여시력정부상관；련접체단렬조시력교완정조저；존재황반전막조시력교저.(4) OCT여FFA대황반수종적검출일치솔위86.39％.결론 포도막염소도치적황반수종기형태가표현위다충불동적류형,OCT가이대저사개변진행유효관찰,기중유사개변여시력밀절상관.
Objective To describe the morphologic characteristics of uveitic macular edema by the use of optical coherence tomography (OCT) and to investigate the correlation between tomographic features and visual acuity (VA). Methods OCT was performed in 169 eyes of 107 patients with uveitis who with a clinical diagnosis of macular edema.The different types of macular edema,the foveal thickness,epiretinal membrane formation were observed,and the correlation between VA and foveal thickness,photoreceptor integrity were analyzed.The OCT results were compared with angiographic appearance of macular edema. Results (1)There were 3 patterns of macular edema:cystoid macular edema (43.19％),diffuse macular edema (34.91％),and serous retinal detachment (10.06％),11.83％ with 3 patterns in the same eye.(2) Disrupted photoreceptor integrity was detected in 54eyes (31.95％),epiretinal membrane in 33 eyes (19.53％),15 eyes ( 8.88％ ) demonstrated vitreomacular traction.(3) CME had higher mean foveal thickness than DME.Foveal thickness in both CME and DME correlate negatively with VA.The integrity of the photoreceptor layer,epiretinal membrane formation was associated with the VA.(4) The consistent of OCT and FFA for detecting macular edema was 86.39％. Conclusions OCT are useful diagnostic tools for the evaluation of uveitie macular edema,the morphologic features of macular edema and macular thickness correlated with VA.