CAJ | 학술논문

目的观察一组视力下降,而眼底及荧光素眼底血管造影(FFA)均正常的眼外伤患眼的黄斑区“频域光相干断层扫描(FD-OCT)”检查的图像特征.方法回顾性病例分析,选择2009年12月至2011年12月我院门诊就诊的25例视力下降,眼底及FFA检查均未发现异常的眼外伤为研究对象,回顾分析外伤眼(25眼)及对侧健眼(25眼)的FD-OCT检查资料,比较外伤眼(外伤组)及对侧健眼(正常组)的黄斑区视网膜厚度及形态改变,并分析外伤组最佳矫正LogMar视力敏感度与黄斑中心视网膜厚度的相关性.结果正常组平均黄斑中心视网膜厚度为(192.81±14.74) μm;外伤组平均黄斑中心视网膜厚度为(128.09±41.63) μm,外伤组黄斑中心视网膜厚度较正常组降低(t=5.836,P＜0.001).外伤组中,黄斑中心视网膜厚度与最佳矫正LogMar视力敏感度呈负相关,(r=-0.689,P=0.001).FD-OCT形态比较,两组黄斑中心凹曲线正常,外伤组黄斑区光感受器细胞外节及内外节连接(IS/OS)均出现不同程度损害,其中光感受器细胞外节及IS/OS反射局部断裂6例6眼；光感受器细胞外节反射消失,IS/OS脱失不连续伴外核层轻、中度变薄11例11眼；光感受器细胞外节及IS/OS反射消失,外核层明显变薄8例8眼.结论 FD-OCT能发现常规检查不能发现的黄斑区光感受器微结构变化,其影像学特征可为外伤性黄斑病变的诊断及病情评估提供帮助.
목적 관찰일조시력하강,이안저급형광소안저혈관조영(FFA)균정상적안외상환안적황반구“빈역광상간단층소묘(FD-OCT)”검사적도상특정.방법 회고성병례분석,선택2009년12월지2011년12월아원문진취진적25례시력하강,안저급FFA검사균미발현이상적안외상위연구대상,회고분석외상안(25안)급대측건안(25안)적FD-OCT검사자료,비교외상안(외상조)급대측건안(정상조)적황반구시망막후도급형태개변,병분석외상조최가교정LogMar시력민감도여황반중심시망막후도적상관성.결과 정상조평균황반중심시망막후도위(192.81±14.74) μm;외상조평균황반중심시망막후도위(128.09±41.63) μm,외상조황반중심시망막후도교정상조강저(t=5.836,P＜0.001).외상조중,황반중심시망막후도여최가교정LogMar시력민감도정부상관,(r=-0.689,P=0.001).FD-OCT형태비교,량조황반중심요곡선정상,외상조황반구광감수기세포외절급내외절련접(IS/OS)균출현불동정도손해,기중광감수기세포외절급IS/OS반사국부단렬6례6안；광감수기세포외절반사소실,IS/OS탈실불련속반외핵층경、중도변박11례11안；광감수기세포외절급IS/OS반사소실,외핵층명현변박8례8안.결론 FD-OCT능발현상규검사불능발현적황반구광감수기미결구변화,기영상학특정가위외상성황반병변적진단급병정평고제공방조.
Objective To observe the macular image characteristics of frequency domain optical coherent tomography (FD-OCT) in a series of patients with ocular trauma who complained of visual decline but with normal funds photography and funds fluorescein angiography (FFA).Methods Retrospective case series.25 cases of out-patients who complained of visual decline with ocular trauma but which fundus and FFA examinations could not be found abnormal were enrolled in the study from December 2009 to December 2011in our hospital.FD-OCT images of traumatic eyes (25 eyes) and the contralateral eyes without ocular trauma (25 eyes) were retrospectively analyzed.Retinal thickness and morphological changes at the macular fovea of FD-OCT images were compared between the traumatic eyes (trauma group) and the contralateral eyes without ocular trauma (normal group).The correlation between the LogMar best-corrected visual acuity and retinal thickness of the trauma group was evaluated.Results Retinal thickness in the macular fovea of the normal group and the trauma group were (192.81 ± 14.74) μm and (128 ± 41.63) μm.Retinal thickness of the trauma group was significantly decreased comparing with normal group (t =5.836,P ＜ 0.001),and there was a negative correlation between the thickness of macular fovea and LogMar best-corrected visual acuity in the trauma group (r =-0.689,P =0.001).FD-OCT images showed both groups had normal macular curve.In the trauma group,the status of the inner and outer segments (IS/OS) photoreceptor junction and outer segments photoreceptor were all appeared damages:the IS/OS junction line and outer segments photoreceptor were discontinuous in 6 cases (6 eyes) ; outer segments photoreceptor disappeared and IS/OS junction line discontinuous accompanied by thinning of the retina in 11 cases (11 eyes) ; outer segments photoreceptor and IS/OS junction line disappeared accompanied by retinal thickness significantly thinner in 8 cases (8 eyes).Conclusion FD-OCT can display the photoreceptor microstructure changes of macular fovea,which can not be detected by routine examinations.The images may be useful for evaluation and clinical diagnosis of traumatic macular disease.