黄斑区盘状水肿及囊样水肿的光学相干断层扫描图像观察.DOCVIP

临床医学论文-黄斑区盘状水肿及囊样水肿的光学相干断层扫描图像观察 ??????????????????????????????? 作者：马国嫣，李冬，王禹，解聪?? 【摘要】? 目的：观察黄斑区盘状水肿和囊样水肿在光学相干断层扫描图像上的不同。方法：对经过散瞳后直接、间接检眼镜及荧光素眼底血管造影检查已确诊的32例致黄斑区盘状水肿的中心性浆液性脉络膜视网膜病变患者及28例致黄斑区囊样水肿的视网膜静脉阻塞患者进行光学相干断层扫描检查。 结果：盘状水肿表现为神经上皮层增厚，神经上皮层隆起和色素上皮之间为液性暗腔，色素上皮层光带变薄，或伴有1处或多处的色素上皮层隆起，下方为液性暗腔。且色素上皮的脱离是局限的。囊样水肿表现为神经上皮间有1个或数个液性暗腔，呈蜂窝状，表面组织菲薄，伴有神经上皮层脱离、增厚。结论：盘状水肿主要是神经上皮层的脱离，神经上皮层间无明显改变。囊样水肿主要是神经上皮间形成蜂窝状液性暗腔。 【关键词】? 盘状水肿；囊样水肿；光学相干断层扫描 　　Observation of Optical Coherence Tomograhpy Images of Discal Macular Edema and Cystoid Macular Edema 　　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 　　黄斑水肿导致患者视力下降、视物变形。以往的检查手段不能显示出黄斑水肿时视网膜细微结构的变化,现在由于光学相干断层扫描技术的发明弥补了这项空白。现将主要的两种黄斑水肿在光学相干断层扫描(OCT)检查上的不同报告如下。 　　1? 对象和方法 　　对2003年5月至2004年7月于我院就诊的中心性浆液性脉络膜视网膜病变及视网膜静脉阻塞患者进行筛选。散瞳后用直接、间接检眼镜及荧光素眼底血管造影（FFA）检查选出32例致黄斑盘状水肿的中心性浆液性脉络膜视网膜病变患者及28例致黄斑囊样水肿的视网膜静脉阻塞患者。中心性浆液性脉络膜视网膜病变患者年龄23岁～45岁，男25例，女7例，单眼患病，左眼15例，右眼17例。视网膜静脉阻塞患者年龄40岁～68岁，男12例，女16例，单眼患病，左眼10例，右眼18例。对以上患者进行OCT检查。采用ZeissHumpherey OCT仪，扫描深度2 mm，图像像素500