黃斑區(qū)盤狀水腫及囊樣水腫的光學(xué)相干斷層掃描圖像觀察
作者：馬國嫣，李冬，王禹，解聰【摘要】 目的：觀察黃斑區(qū)盤狀水腫和囊樣水腫在光學(xué)相干斷層掃描圖像上的不同。方法：對(duì)經(jīng)過散瞳后直接、間接檢眼鏡及熒光素眼底血管造影檢查已確診的32例致黃斑區(qū)盤狀水腫的中心性漿液性脈絡(luò)膜視網(wǎng)膜病變患者及28例致黃斑區(qū)囊樣水腫的視網(wǎng)膜靜脈阻塞患者進(jìn)行光學(xué)相干斷層掃描檢查。 結(jié)果：盤狀水腫表現(xiàn)為神經(jīng)上皮層增厚，神經(jīng)上皮層隆起和色素上皮之間為液性暗腔，色素上皮層光帶變薄，或伴有1處或多處的色素上皮層隆起，下方為液性暗腔。且色素上皮的脫離是局限的。囊樣水腫表現(xiàn)為神經(jīng)上皮間有1個(gè)或數(shù)個(gè)液性暗腔，呈蜂窩狀，表面組織菲薄，伴有神經(jīng)上皮層脫離、增厚。結(jié)論：盤狀水腫主要是神經(jīng)上皮層的脫離，神經(jīng)上皮層間無明顯改變。囊樣水腫主要是神經(jīng)上皮間形成蜂窩狀液性暗腔。
【關(guān)鍵詞】 盤狀水腫；囊樣水腫；光學(xué)相干斷層掃描
Observation of Optical Coherence Tomograhpy Images of Discal Macular Edema and Cystoid Macular Edema 論文網(wǎng)在線
Abstract： Objective To abserve the difference between discal macular edema(DME) and cystoid macular edema(CME). Methods 32 patients with DME and 28 retinal vein occlusion patients with CME were diagnosed with direct ophthalmoscope, indirect ophthalmoscope and fundus fluorescence angiography examing were cxamed with optical coherence tomography(OCT). Results DEM representation is nerve epithelium thick, hunch and with liquid dark cavity between pigmentary epithelium;pigmentary epithalium is thin with one or more pigmentary epithdium hurch,, its inferior is liquid dark cavity, and the detachment of pigmentary epithelium is limited. CME representation is one or more liquid dark ,cavity haney comb ,the exterior tissue is poor thin and nerveepithelium detechment. Conclusion DME mostly representatione is nerve epithelium detechment and inter bedded,tissne has no change. CME mostly representatione is that nerve epithelium formed liquid dark cavity as horeycomb.
Key words：Discal macular edema; Cystoid macular edema; Optical coherence tomograhpy
黃斑水腫導(dǎo)致患者視力下降、視物變形。以往的檢查手段不能顯示出黃斑水腫時(shí)視網(wǎng)膜細(xì)微結(jié)構(gòu)的.變化,現(xiàn)在由于光學(xué)相干斷層掃描技術(shù)的發(fā)明彌補(bǔ)了這項(xiàng)空白。現(xiàn)將主要的兩種黃斑水腫在光學(xué)相干斷層掃描(OCT)檢查上的不同報(bào)告如下。
1 對(duì)象和方法
對(duì)2003年5月至2004年7月于我院就診的中心性漿液性脈絡(luò)膜視網(wǎng)膜病變及視網(wǎng)膜靜脈阻塞患者進(jìn)行篩選。散瞳后用直接、間接檢眼鏡及熒光素眼底血管造影（FFA）檢查選出32例致黃斑盤狀水腫的中心性漿液性脈絡(luò)膜視網(wǎng)膜病變患者及28例致黃斑囊樣水腫的視網(wǎng)膜靜脈阻塞患者。中心性漿液性脈絡(luò)膜視網(wǎng)膜病變患者年齡23歲～45歲，男25例，女7例，單眼患病，左眼15例，右眼17例。視網(wǎng)膜靜脈阻塞患者年齡40歲～68歲，男12例，女16例，單眼患病，左眼10例，右眼18例。對(duì)以上患者進(jìn)行OCT檢查。采用Zeiss?Humpherey OCT儀，掃描深度2 mm，圖像像素500×500，操作集中在黃斑區(qū)，以通過中心凹的等長(zhǎng)度和等角度間隔的8線掃描。
2 結(jié)果
2.1 FFA改變 32例中心性漿液性脈絡(luò)膜視網(wǎng)膜病變中3例無異常改變，3例于后極部見窗樣缺損，26例于后極部見熒光滲漏點(diǎn)呈圓形、蘑菇云狀、炊煙狀擴(kuò)大，見圖2。28例視網(wǎng)膜靜脈阻塞黃斑區(qū)花瓣?duì)顭晒夥e存，見圖1。
【黃斑區(qū)盤狀水腫及囊樣水腫的光學(xué)相干斷層掃描圖像觀察】相關(guān)文章：
1.中醫(yī)執(zhí)業(yè)醫(yī)師考點(diǎn)：水腫的病機(jī)要點(diǎn)
2.中醫(yī)助理醫(yī)師考點(diǎn)：水腫病機(jī)要點(diǎn)
3.臨床執(zhí)業(yè)醫(yī)師助理考點(diǎn)：細(xì)胞水腫和病理變化
4.光學(xué)遙感圖像多目標(biāo)檢測(cè)及識(shí)別算法設(shè)計(jì)與實(shí)現(xiàn)
5.無創(chuàng)機(jī)械通氣在治療急性心源性肺水腫中的作用探索
6.婦產(chǎn)科主治醫(yī)師知識(shí)點(diǎn)：胎水腫滿的病因病機(jī)
7.中西醫(yī)結(jié)合助理執(zhí)業(yè)醫(yī)師考點(diǎn)：水腫病因病機(jī)