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目的研究外伤性黄斑病变的相干光断层扫描(OCT)图像特征,以总结其患病规律。设计回顾性病例系列。研究对象477例(486眼)4～76岁的外伤性黄斑病变患者。方法回顾及分析2002年9月～2009年6月在北京同仁医院眼科门诊就诊的不同类型外伤性黄斑病变患者的门诊病历资料及OCT图像。主要指标OCT图像特征。结果外伤性黄斑病变的OCT表现主要有九种:黄斑裂孔、神经上皮层脱离、黄斑出血、黄斑水肿、黄斑前膜、脉络膜破裂、黄斑部神经上皮层萎缩薄变、色素上皮层萎缩及脉络膜萎缩。在外伤的早期,较常见的OCT表现为黄斑部色素上皮层萎缩(49.0%)、黄斑裂孔(24.7%)、神经上皮层脱离(26.3%)、黄斑出血(24.2%)、黄斑水肿(19.2%);在外伤的中晚期,较常见的OCT表现为黄斑部色素上皮层萎缩(63.0%)、神经上皮层萎缩薄变(36.5%)。结论外伤性黄斑病变以多种OCT表现并存为多,黄斑部视网膜色素上皮层萎缩是贯穿外伤早期、中晚期最多的表现。外伤性黄斑病变早期以黄斑裂孔、视网膜脱离、黄斑出血、黄斑水肿为主,中晚期以黄斑部神经上皮层及色素上皮层萎缩为主。
Objective To study the characteristics of coherent light tomography (OCT) in patients with traumatic maculopathy to summarize its prevalence. Design retrospective case series. Subjects 477 cases (486 eyes) 4 to 76 years old patients with traumatic maculopathy. Methods The outpatient records and OCT images of patients with different types of traumatic maculopathy treated at the ophthalmology clinic of Beijing Tongren Hospital from September 2002 to June 2009 were reviewed and analyzed. The main indicators of OCT image characteristics. Results There were nine main manifestations of OCT in macular degeneration: macular hole, neuroepithelial detachment, macular hemorrhage, macular edema, macula, choroidal rupture, atrophy and thinning of macular epithelium, atrophy of pigment epithelium and choroidal atrophy . In the early stage of trauma, the more common OCT showed macular atrophy (49.0%), macular hole (24.7%), neuroepithelial detachment (26.3%), macular hemorrhage (24.2%), macular edema (19.2% ). In the middle and late stages of trauma, the more common OCT showed atrophy of the macular pigment epithelium (63.0%) and thinning (36.5%) of the neuroepithelial cortex. Conclusion Traumatic macular degeneration is characterized by multiple OCT manifestations. The atrophy of the macular retinal pigment epithelium is the most frequent manifestation of the trauma through the early and middle stages of trauma. Traumatic macular degeneration in the early macular hole, retinal detachment, macular hemorrhage, macular edema-based, in the late macular degeneration and epithelial atrophy based.