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目的观察萎缩型,渗出型老年黄斑变性(Age-relatedmaculardegenerationAMD)患者的光学相干断层扫描图像特征。比较光学相干断层扫描(OpticalCoherenceTomographyOCT)和荧光血管造影(FluoresceinangiographyFFA)的特点,对脉络膜新生血管(ChoroidalneovascularizationCNV)进行OCT分型。方法经FFA确诊的AMD57例76只[进行OCT检查。结果AMD患者色素上皮萎缩,软性玻璃膜疣,神经上皮和色素上皮脱离具有特有的OCT特征,OCT图像中视网膜神经上皮增厚、隆起反映视网膜下,视网膜层间积液。神经上皮或色素上皮(Retinalpigmentepithelium,RPE)隆起,其下低反射区反映神经上皮或RPE层脱离。CNV的OCT图像分为边界清晰的CNV,边界模糊的CNV,纤维血管性RPE脱离。FFA中的典型性CNV相当于OCT图像中边界清晰CNV,隐匿性CNV相当于OCT图像中边界模糊CNV和纤维血管性RPE脱离。结论OCT能特征性显示AMD中视网膜神经上皮隆起,视网膜层间积液,出血,神经上皮和RPE的脱离,且显示不同类型CNV的OCT特征。
Objective To observe the characteristics of optical coherence tomography in patients with atrophic and exudative AMD (age-related macular degeneration). To compare the characteristics of Optical Coherence Tomography (OCT) and Fluorescein angiography (FFA), and to classify the choroidal neovascularization (CNV) by OCT. METHODS: Sixty-five AMD 57 patients confirmed by FFA were examined by OCT. Results In patients with AMD, pigment epithelial atrophy, soft drusen, neuroepithelial and pigmented epithelial detachment had characteristic OCT features. The retinal neuroepithelial thickened in OCT images, and the uplift reflected the subretinal and retinal layer effusion. The neuroepithelial or retinal pigment epithelium (RPE) is elevated, and the underlying low-reflex zone reflects the detachment of the neural epithelium or RPE layer. The OCT images of CNV were divided into clear border CNV, blurred border CNV and fibrovascular RPE. Typical CNV in FFA is equivalent to clear CNV in the border of OCT images, and occult CNV is equivalent to borderline blurred CNV and fibrovascular RPE detachment in OCT images. Conclusions OCT can characteristically display retinal neuroepithelial uplift, retinal layer effusion, hemorrhage, neuroepithelial and RPE detachment in AMD and show OCT characteristics of different types of CNV.