摘要
目的 观察萎缩型老年性黄斑变性（AMD）玻璃膜疣患者的频域光相干断层扫描（SD-OCT）图像特征.方法 临床确诊为黄斑区玻璃膜疣的萎缩型AMD患者54例84只眼及老年性白内障患者56例56只眼（对照组）纳入研究.84只萎缩型AMD患眼中,玻璃膜疣累及黄斑中心小凹500 μm内42只眼（D1组）,玻璃膜疣距离黄斑中心小凹500～3000 μm 42只眼（D2组）.采用SD-OCT检查获取以黄斑中心凹为中心6 mm×6 mm区域的视网膜断层图像,测量黄斑中心小凹视网膜厚度（FRT）;观察患眼玻璃膜疣的大小、形状、内部反射性密度、内部反射性是否均一以及玻璃膜疣对周围组织的损伤情况.结果 D1组、D2组及对照组FRT分别为（160.90±38.47）、（194.21±26.11）、（222.42±19.29） μm,3组间FRT比较,差异有统计学意义（F=57.08,P=0.00）.SD-OCT于84只眼中检出1124个玻璃膜疣,平均每只眼检出玻璃膜疣10.84个.1124个玻璃膜疣中,小玻璃膜疣34个,占3.0％;中等大小玻璃膜疣140个,占12.5％;大玻璃膜疣950个,占84.5％.形状为圆顶形635个,占56.6％;尖形160个,占14.2％;锯齿形229个,占20.4％;扁平形99个,占8.8％.内部反射性密度为弱反射性192个,占17.1％;中等反射性646个,占57.5％;强反射性286个,占25.4％.内部反射性表现为反射均质737个,占65.6％;反射非均质无核356个,占31.7％;反射非均质有核31个,占2.8％.伴视网膜色素上皮（RPE）损害388个,占34.5％;不伴RPE损害736个,占65.5％.伴光感受器内外节连接（IS/OS）损害279个,占24.8％;不伴IS/OS损害845个,占75.2％.84只眼中,最常见的玻璃膜疣类型为圆顶形、内部反射性密度为中等反射、内部反射性为反射均质,不伴RPE或IS/OS损害的玻璃膜疣,共68只眼,占81.0％.结论 萎缩型AMD玻璃膜疣患者的FRT变薄,玻璃膜疣类型最常见的为圆顶形、内部反射性密度为中等反射、内部反射性为反射均质,不伴RPE或IS/OS损害的玻璃膜疣.
Objective To observe the morphologic characteristics of drusen in atrophic age-related macular degeneration （AMD） by spectral domain optical coherence tomography （SD-OCT）.Methods Fifty-four patients （84 eyes） with macular drusen and atrophic AMD,and 56 age-matched control patients （56 eyes） with cataract were included in this study.Atrophic AMD patients were divided into two groups：D1 group with drusen involving the fovea （42 eyes） and D2 group with drusen not involving the fovea （42 eyes）.The SD-OCT images in macular （6 mm×6 mm scans） were acquired,and the foveal retinal thickness （FRT） was measured.The size,morphology,inner reflection,homogeneity of drusen and its relationship with surrounding tissues were analyzed.Results The FRT of D1 group,D2 group and control group were （160.90±38.47）,（194.21±26.11）,（222.42± 19.29） μm respectively.The FRT of D1 group and D2 group were thinner than that of control group （F=57.08,P=0.00）.Totally 1124 drusen were found by SD-OCT images in 84 eyes,with an average of 10.84 drusen in each eye.3.0%,12.5% and 84.5% of all 1124 drusen were small,medium and large sized respectively.56.6%,14.2%,20.4% and 8.8% of all drusen were dome,pointed,saw-toothed and basal-shaped respectively.17.1 %,57.5% and 25.4% of all drusen had low,medium and high internal reflectivity respectively.The internal reflectivity of 65.6%,2.8% and 31.7% of all drusen were homogeneous,nonhomogeneous with core,and nonhomogeneous without core respectively.Overlying retinal pigment epithelium （RPE） damage and photoreceptor inner segment/outer segment （IS/OS） junction damage were presented in 34.5 % and 24.8 % drusen respectively.The most common type of drusen was dome-shape,homogeneous,with medium internal reflectivity,and without overlying RPE or IS/OS junction damage （81.0%）.Conclusions The FRT becomes thinner in patients with drusen.The most common drusen types are dome-shaped,homogeneous,with medium internal reflectivity,and without overlying RPE or IS/OS junction damage.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2014年第3期261-265,共5页
Chinese Journal of Ocular Fundus Diseases
基金
广东省科技计划项目（2012B050600032）
广东省医学科研基金（B2013139）
关键词
视网膜小疣
诊断
体层摄影术
光学相干
黄斑变性
诊断
诊断显像
Retinal drusen/diagnosis
Tomography,optical coherence
Macular degeneration/ diagnosis
Diagnostic imaging
