目的:探讨光学相干断层扫描(optical coherence tomography,OCT)在老年性白内障行超声乳化吸除术前检查中的临床意义。方法:选择尚可看见眼底,直接及间接眼底镜检查正常或仅表现为黄斑中心凹反光消失的老年性白内障患者400例400眼,包括糖尿病史者100例,高度近视者60例,术前除了进行全面详细的眼科常规检查外,进行黄斑区OCT检查。计算眼底镜检查的漏诊率及白内障并发黄斑病变一般危险因素的相对危险度。结果:术前OCT检查发现黄斑病变28例,包括黄斑水肿12例,老年性黄斑变性10例,玻璃体黄斑牵拉2例,黄斑区出血1例,黄斑裂孔2例,黄斑萎缩1例。糖尿病、高度近视、年龄>60岁的相对危险度及95%可信区间分别为:4(1.837,8.087),2.27(1.050,4.9),2.5(1.14,5.53)。结论:OCT在老年性白内障行超声乳化吸除术前检查中对合并的黄斑病变检查灵敏度高,尤其是对于年龄>60岁、高度近视和糖尿病史患者,可作为术前常规检查。

AIM:To evaluate the clinical value of optical coherence tomography(OCT)in age-related cataract before phacoemulsification.METHODS:Four hundred cases 400 eyes of age-related cataract with normal fundus or only loss of foveal reflex under direct and indirect funduscopes were selected for study,including 100 cases with diabetic history,60 cases with high myopia.Besides traditional detailed ophthalmology examinations,all the subjects underwent macular exam with OCT before surgery.The omission diagnose rate of funduscopes and the risk ratio of general risk factors were calculated.RESULTS:Twenty-eight cases of maculopathy were found by OCT before cataract surgery,including 12 cases of macular edema,10 cases of age-related macular degeneration,2 cases of vitreomacular traction,1 case of macular hemorrhage,2 cases of macular hole and one case of macular atrophy.Diabetic history,high myopia and age above 60 years old were risk factors,and risk ratio with 95% confidence interval were 4(1.837,8.087),2.27(1.050,4.9),2.5(1.14,5.53)respectively.CONCLUSION:OCT is highly sensible in suspection of maculopathy before cataract surgery,especially for patients with diabetes,high myopia and old age,it can be recommended as preoperational routine examination.

R776.1