摘要
目的评价使用光学相干断层扫描(optical coherence tomography,OCT)对恶性高血压性视网膜病变疗效观察的有效性。方法对26例(31眼)恶性高血压性视网膜病变患者的资料进行回顾性分析,对比分析治疗前及治疗后15 d、1个月、3个月时的视力、视盘周围视网膜神经纤维层厚度、黄斑区视网膜神经上皮层厚度和黄斑区6 mm直径神经上皮总体容积的变化。结果与治疗前相比,治疗后15 d视力提高者22眼,治疗后1个月为26眼,治疗后3个月为29眼。患者视盘周围视网膜神经纤维层厚度及黄斑区视网膜神经上皮层厚度治疗前为(393.20±18.05)μm和(486.58±69.00)μm,治疗后15 d、1个月、3个月分别为(363.20±26.80)μm和(392.13±30.65)μm、(342.75±25.82)μm和(315.03±22.33)μm、(305.64±23.38)μm和(213.87±25.68)μm;黄斑区6 mm直径神经上皮总体容积治疗前为(17.04±3.31)mm3,治疗后15 d、1个月、3个月分别为(11.07±2.02)mm3、(9.36±0.93)mm3、(8.42±0.75)mm3;各指标与治疗前比较差异均具有统计学意义(均为P<0.05),治疗后各时间点间两两比较差异亦均有统计学意义(均为P<0.05)。结论恶性高血压性视网膜病变的视盘周围视网膜神经纤维层厚度、黄斑区视网膜神经上皮层厚度和黄斑区6 mm直径神经上皮总体容积变化与其病变程度相关,OCT对恶性高血压性视网膜病变疗效评价具有重要意义,能够为病情的追踪和指导用药提供客观依据。
Objective To observe the clinical effects of malignant hypertensive retinopathy with optical coherence tom ography（ OCT）. Methods Twenty-six patients（ 31 eyes） with malignant hypertensive retinopathy were retrospectively analyzed. The visual acuity,retinal nerve fiber layer thickness around the optic disc,m acular retinal neuroepithelial layer thickness and total volum e of macular neuroepithelium with diam eter of 3 mm were exam ined by OCT before and 1 5 days,1 m onth,3 m onths after treatm ent. Results Compared with that before treatm ent,the visual acuity after treatm ent was im proved in 2 2 eyes,2 6 eyes and 2 9 eyes at 1 5 days,1 m onth and 3 m onths after treatm ent,respectively. The retinal nerve fiber layer thickness around the optic disc and macular retinal neuroepithelial layer thickness before treatment were（ 393. 20 ± 18. 05） μm and（ 486. 58 ±69. 00） μm,respectively,which at 15 days after treatment were（ 363. 20 ± 26. 80） μm and（ 392. 13± 30. 65） μm,respectively,which at 3 months after treatment were（ 342. 75 ± 25. 82） μm and（ 315. 03 ±22. 33） μm,respectively,which at 6 months after treatment were（ 305. 64 ± 23. 38） μm and（ 213. 87 ± 25. 68） μm,respectively. The total volume of macular neuroepithelium before treatment was（ 17. 04 ± 3. 31） mm3,which at 15 days,1 month and 3 months after treatment were（ 11. 07 ± 2. 02） mm3,（ 9. 36 ± 0. 93） mm3,（ 8. 42 ± 0. 75） mm3,respectively. There were statistical differences in above all indexes before and after treatment（ all P 0. 05）,and there were statistical differences in above all indexes between each two time points after treatment（ all P〈 0.05）. Conclusion The changes of retinal nerve fiber layer thickness around the optic disc,macular retinal neuroepithelial layer thickness and total volume of macular neuroepithelium are associated with the severity of malignant hypertensive retinopathy. OCT is helpful to evaluate the clinical effects of malignant hypertensive retinopathy,provides the objective basis for tracking the disease and guiding therapy.
出处
《眼科新进展》
CAS
北大核心
2016年第4期365-367,共3页
Recent Advances in Ophthalmology
