特发性和继发性黄斑前膜频域OCT的对比研究

Comparison of idiopathic and secondary macular epiretinal membranes using frequency domain OCT

摘要:

目的： 应用频域光学相干断层扫描(optical coherence tomography， OCT)对特发性和继发性黄斑前膜(macular epiretinal membrane， ERM)的形态特征、黄斑中心凹厚度及其与视力的关系进行对比研究。

方法：应用频域OCT观察用裂隙灯显微镜、荧光素眼底血管造影(fundus fluorescein angiography，FFA)及OCT确诊为特发性ERM(92例112眼)、继发性ERM(78例96眼)的患者，观察前膜的形态特征、定量测量前膜及其下视网膜厚度、分析黄斑中心凹厚度与视力的关系。

结果：ERM的OCT图像表现为视网膜神经上皮层表面厚薄不一的高反射光带，主要表现为前膜与视网膜内表面出现局灶及大部分粘连，其次表现为黄斑中心凹变浅或消失、神经上皮层增厚、黄斑水肿。特发性ERM患者视网膜平均厚度为398.32±112.07μm，前膜的平均厚度为52.28±9.65μm； 继发性ERM患者视网膜平均厚度为416.87±104.17μm，前膜的平均厚度为57.05±10.33μm。两组间的差异无统计学意义(P>0.05)。在相同视力区间，两组黄斑中心凹厚度比较，差异无统计学意义(P>0.05)。而分别在两组及同组不同视力区间之间，黄斑中心凹厚度差异有统计学意义(P <0.05)。

结论：OCT可以客观地显示ERM及黄斑部组织结构的改变， 并能定量检测ERM、中心凹视网膜厚度变化，是ERM可靠的检测手段。

Abstract:

AIM:To compare frequency domain optical coherence tomography(OCT)images of idiopathic macular epiretinal membrane(ERM)with those of secondary ERM and analyze the influence on visual acuity

METHODS:Clinical data of 92 idiopathic ERM patients(112 eyes)and 78 secondary ERM patients(96 eyes)diagnosed with slit lamp microscope, fundus fluorescein angiography(FFA)and OCT. The morphological changes of ERM, central foveal thickness in all cases were recorded and analyzed by OCT.

RESULTS: ERM was visible on OCT as high reflective tissue which was focal points of attachment or globally adherent to the underlying retina. In part of fovea, the depth decreased, the thickness increased and macular became edema. The mean retina thickness in patients with idiopathic ERM was 398.32±112.07μm and the mean thickness of ERM was 52.28±9.65μm vs 416.87±104.17μm and 57.05±10.33μm in patients with secondary ERM respectively, there was no statistical difference between them(P>0.05). In the same range of visual acuity, there was no statistical difference(P>0.05)between idiopathic ERM group and secondary ERM group,but between the different range of visual acuity, the thickness of central fovea of macula was significantly different(P<0.05).

CONCLUSION: OCT can display the ERM and the pathological changes of macular tissues,frequency domain OCT was a particularly useful in the diagnosis of ERM.