摘要
目的对Vogt-小柳-原田病患者黄斑中心凹处频域OCT图像特点进行分析,探讨影响患者视力预后因素。方法经荧光素眼底血管造影确诊的13例(26眼)Vogt-小柳-原田病患者,皮质激素治疗前和治疗后1周、1个月、3个月、6个月进行频域OCT检查,对黄斑中心凹处OCT图像特点进行分析,并对治疗前后视力、眼底进行观察。结果糖皮质激素治疗后1周42.3%的患眼视力≥0.4,治疗后3个月、6个月≥0.4者分别为73.1%、80.8%。治疗后1个月,大部分荧光素眼底血管造影正常,仅3眼有轻度视盘渗漏。治疗后3个月、6个月,荧光素眼底血管造影23眼未见异常,3眼出现色素紊乱。在皮质激素治疗前,26眼中有25眼(96.1%)黄斑中心凹处存在浆液性视网膜脱离,高度为(341±123)μm。有10眼(38.5%)视网膜层间有囊样间隙的存在,在囊样间隙的底部可见一连续单一的膜样结构平铺于视网膜色素上皮之上,此膜样结构和周围的IS/OS相连续。治疗1周后,25眼中有24眼(96.0%)浆液性视网膜脱离仍然存在,但是视网膜下液明显吸收,其高度为(118±56)μm,比治疗前平均下降65.4%,治疗前后差异有显著统计学意义(P<0.01)。8眼视网膜层间囊样间隙完全消失。治疗后1个月,26眼浆液性视网膜脱离和视网膜层间囊样间隙全部消失。治疗后3个月及6个月,黄斑中心凹OCT图像基本正常。结论浆液性视网膜脱离是Vogt-小柳-原田病频域OCT图像的共有特点,部分患者视网膜出现层间囊样间隙,此囊样间隙好发于视网膜内外层之间。通过皮质激素治疗,浆液性视网膜脱离和视网膜层间囊样间隙均可吸收消失,但视网膜层间囊样间隙的消失要快于浆液性视网膜脱离。
Objective To explore factors that could affect prognosis of visual a- cuity by analyzing spectral-domain optical coherence tomography（OCT） image features of central fovea of macula in patients with different stages of Vogt-Koyanagi-Harada （VKI-I） disease. Methods Thirteen cases （26 eyes ） that had been confLrmed with VKH by fundus fluorescein angiography （FFA） were recruited, and all the cases were given glucocorticosteroid treatment. Spectral-domain OCT were performed on all the cases at five time-points ： before the treatment, 1 week, 1 month, 3 months and 5 months after the treatment. OCT image features of central fovea of macula were then analyzed. Preand postoperative vision and fundus colorized photography were also observed. Results Percentage of eyes with a Vision not lower than 0.4 at 1 week after treatment was 42.3% ,that at 3 months,6 months after treatment were 73.1% and 80. 8% ,respectively. According to FFA results,most eyes were nomlal and 3 eyes were found with ninor leakage at the 3rd time-point;Twenty-three eyes were normal and 3 eyes were found with pigmentation disorder at the 4th and 5th time-points. At the 1st time-point,25 eyes （96.1%） were found with serous retinal detachment in central fovea of macula, and the average height was（341 ± 123）;Ten eyes（38.5% ） were found with cystoid intervals between layers of retina, single prolonged membranous structure was found at the bottom of the cystoid intervals, which tiled on the retinal layer and linked with the photoreceptor inner and outer segments（IS/OS）. At the 2nd time-point 24 eyes were still found with se rous retinal detachment, but the condition had improved obviously：the average height had an average significant drop of 65.4% and became（ 118 ± 56） m（P 〈 0. 01 ）. Eight eyes were found no cystoid intervals. At the 3rd time-point, serous retinal detachment and cystold intervals in all eyes disappeared. At the 4th and 5th time-points, OCT image of central fovea of macula in almost all eyes were normal. Conclusion Serous retinal detachmentis tie coonfeattu：e of sPectromain OCT image of VKH, some patients can also be found with cystoid intervals between retinal layers. The latter are common between the inner and the outer membrane of retina. Both of the two conditions could be cured by glucocorticosteroid treatment,while the latter takes less time to vanish than the former.
出处
《眼科新进展》
CAS
北大核心
2013年第6期555-557,561,共4页
Recent Advances in Ophthalmology
基金
中国博士后基金资助(编号:2012M521877)~~
