眼前节OCT在闭合性眼外伤患者中的应用

Anterior segment spectral-domain optical coherence tomography in patients with closed globe injury

摘要:

目的：比较光谱域光学相干断层扫描(SD-OCT)和裂隙灯生物显微镜对闭合性眼球损伤患者眼前节病变的检测能力。

方法：这是一项观察性横断面研究。2010-01/2015-07，在惠州市中心人民医院连续招募了16名闭合性眼球损伤患者。所有患者均行完整的眼科检查，包括视力评估、非接触眼压测量和裂隙灯生物显微镜检查。采用SD-OCT检查所有损伤眼的前段。两名患者双侧眼外伤，接受双侧SD-OCT检查。记录角膜、虹膜、前房和晶状体的OCT表现，并与裂隙灯生物显微镜检查结果进行比较。

结果：所纳入的18眼均合并前房积血，且前房积血至少占前房容积的三分之一。16眼在裂隙灯生物显微镜和OCT检查中发现角膜水肿和角膜上皮损伤。OCT检查检出Descemet膜脱离(n=7)，房角退缩(n=6)，晶状体半脱位(n=3)和虹膜根部离断(n=3)。

结论：SD-OCT能鉴别闭式眼球损伤的特征，而在裂隙灯生物显微镜下则看不到这些特征。在闭合性眼球损伤中，SD-OCT可能优于临床检查。

Abstract:

AIM: To compare the ability of spectral-domain optical coherence tomography(SD-OCT)and slit lamp biomicroscopy to detect anterior segment findings in patients with closed globe injury.

METHODS: This is an observational, cross-sectional study. Sixteen patients with a closed globe injury were consecutively recruited from January 2010 to July 2015 in Huizhou Municipal Central Hospital. All patients underwent complete ophthalmic examination, including assessment of visual acuity, measurement of intraocular pressure using a noncontact tonometry, and slit lamp biomicroscopy. SD-OCT was used to examine the anterior segments of all injured eyes. Two patients had bilateral ocular injuries and received bilateral SD-OCT examinations. The OCT findings of the cornea, iris, anterior chamber and lens were recorded and compared with findings seen using slit lamp biomicroscopy.

RESULTS: All 18 eyes were examined by SD-OCT had hyphema occupying at least one-third of the anterior chamber volume. Sixteen eyes had corneal edema and corneal abrasion detected on both slit lamp biomicroscopy and OCT examination. OCT examination was also able to detect Descemet's membrane detachment(n=7), angle recession(n=6), lens subluxation(n=3)and iridodialysis(n=3).

CONCLUSION: SD-OCT was able to identify features of closed globe injury that were otherwise not visible on slit lamp biomicroscopy. SD-OCT may have advantages over clinical examination in cases of closed globe injury.