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目的观察分析海德堡视网膜断层扫描仪(HRT-Ⅱ)对黄斑疾病的检查应用。设计回顾性病例观察研究。研究对象110例黄斑疾病患者201眼。方法用HRT-Ⅱ的黄斑水肿程序(MEM)检查分析正常眼52只、黄斑水肿眼74只、黄斑裂孔眼23只、黄斑前膜眼31只、老年黄斑变性合并脉络膜新生血管(CNV)眼21只。主要指标水肿指数E和信号宽度W及反射图的形态特征。结果正常眼黄斑部分区域水肿指数E和信号宽度W与年龄呈部分相关(r=0.207~0.359)。黄斑疾病各组E值和W值与正常组比较均有极显著性差异(P均=0.000),其中,黄斑水肿组差异最大。HRT-Ⅱ的反射图可显示黄斑囊样水肿的囊腔、黄斑裂孔的形态和大小、黄斑前膜的范围及和血管的关系以及老年黄斑变性中的玻璃膜疣和视网膜下新生血管。结论HRT-Ⅱ不仅可通过反射图显示不同黄斑疾病形态改变,其定量指标E值和W值在黄斑区发生病理改变时不同于正常眼。尤其是中央部E值,代表了黄斑区视网膜厚度和光强反射的共同变化,在黄斑水肿时改变最明显。
Objective To observe the application of Heidelberg Retina Tomography (HRT-II) in macular disease. Design retrospective case observation study. The study included 110 eyes of 201 patients with macular disease. Methods 52 cases of normal eyes, 74 eyes of macular edema, 23 eyes of macular hole, 31 eyes of macular membrane, 31 cases of age-related macular degeneration complicated with choroidal neovascularization (CNV) 21 were examined by macular edema program (HRT-Ⅱ) only. The main indicators of edema index E and signal width W and the morphological characteristics of the reflection map. Results Edema index (E) and signal width (W) in normal macular area were partly related to age (r = 0.207-0.359). The values of E and W in each group were significantly different from those in normal group (P = 0.000). Among them, the difference was the largest in macular edema group. The HRT-II reflectance map shows cysts of macular cystoid edema, the morphology and size of the macular hole, the extent of the macular membrane and its relationship to blood vessels, as well as drusen and subretinal neovascularization in age-related macular degeneration. Conclusion HRT-Ⅱ not only shows the morphological changes of different macular diseases by reflectance map, but also the quantitative index E and W values are different from the normal eyes in pathological changes of macular area. Especially the central E value, represents the common macular retinal thickness and light intensity changes reflect the most obvious changes in macular edema.