临床医学论文-视野和眼B型超声检查在甲状腺相关性眼病诊疗中的临床分析.docVIP

临床医学论文-视野和眼B型超声检查在甲状腺相关性眼病诊疗中的临床分析 ???????????? 作者：钟勇，施维，刘玉华，艾凤荣 【关键词】? 甲状腺相关性眼病；视野；超声,B型；眼 　　［摘要］? 目的? 观察视野和眼B超检查在甲状腺相关性眼病（TAO）的诊断和治疗中的临床价值。方法? 对2000年1月～2006年1月在北京协和医院确诊并接受非手术治疗（包括口服糖皮质激素、放射治疗）的40例TAO患者的66眼进行回顾性分析,分别比较患眼在治疗前后的视野和眼外肌厚度的变化。应用Octopus 101型自动视野计进行视野检查，检查采用TOP程序，59个位点，背景光4 asb，半暗室环境下进行；所有患者均用B超（Quantel Medical）测量眼外肌厚度。结果? 40例患者的66眼均有不同程度的单条或多条眼外肌肉受累，采用不同的治疗方法后，眼外肌的肥厚均有不同程度地好转，比较治疗前后的双眼上、下、内直肌肌肉厚度的改变差异有明显统计学意义（P0.01）;　视野结果显示治疗前后有明显的改善，双眼的平均敏感度（MS）、平均缺陷度（MD）和丢失方差（LV）的变化差异有明显统计学意义（P0.01）。结论? 联合视野和眼B超的检查可以作为TAO的诊断、治疗和预后随诊的常规检查，同时能够提供更为客观和可靠的临床依据,有助于判断TAO患者是否有视神经的受累和评估TAO的临床治疗效果。??? 　　［关键词］? 甲状腺相关性眼病；视野；超声，B型；眼??? 　　Clinical observation of visual field test and ocular ultrasonic examination on the diagnosis and treatment of the thyroid associated ophthalmopathy 　　［Abstract］? Objective? To evaluate the clinical significance of the visual field test and the ocular B-scan ultrasonic examination regarding to the diagnosis and treatment of the thyroid associated ophthalmopathy (TAO).Methods? 40 cases (66 eyes) who were treated by steroids medication and radiotherapy were studied from January 2001 to January 2006 retrospectively.The visual field and thickness of the extra-ocular muscles were tested during pre-therapy and post-therapy.Results? The extra-ocular muscles of 66 eyes showed a various enlargement.The medial,lateral,superior and inferior rectus of both eye presented a significant difference between in pre-therapy and post-therapy.In terms of the visual field test,the mean sensitivity (MS),mean defect (MD) and loss variance (LV) all were statistically significant difference before and after treatment.Conclusion? The combination of visual field and ocular B-scan ultrasonic examination could be a routine test for the diagnosis and follow-up of the TAO patients,which may be of clinical significance to the evaluation of optic neuropathy and the outcome of therapy of the TAO. 　　［Key words］? thyroid associated ophthalmopathy;visual field;ocular ultrasonic exa