光學相干斷層掃描在糖尿病性黃斑水腫患者中的臨床應用研究
發(fā)布時間：2018-12-31 22:26
【摘要】：目的通過采用頻域光學相干斷層掃描儀檢查（SD-OCT）來觀察糖尿病性黃斑水腫患者的黃斑區(qū)視網(wǎng)膜厚度和黃斑區(qū)視網(wǎng)膜光感受器細胞層IS/OS連接的變化，同時對IS/OS連接的形態(tài)改變進行分級，并分析其變化與患者視力的關(guān)系。 方法回顧性病例研究。對2010年11月至2011年6月于我院確診為糖尿病性黃斑水腫(diabetic macular edema，DME)的患者68例（126只眼），，其中男33例，女35例，年齡跨度為39-80歲，平均年齡59.32±9.85歲�；颊呔鶓肧pectralis OCT (HeidelbergEngineering, Dossenheim, Germany)進行檢查，觀察視網(wǎng)膜黃斑區(qū)IS/OS連接的形態(tài)學變化；然后對經(jīng)過黃斑中心凹所做的水平及垂直掃描線進行手動測量以獲得黃斑中心凹厚度值，并取兩者的平均值作為最終的黃斑中心凹厚度（CPT）；進一步應用SD-OCT系統(tǒng)自帶的黃斑地形圖軟件分析測量黃斑部1000um的黃斑中心區(qū)視網(wǎng)膜厚度,以及黃斑部3000um,6000um的兩個直徑范圍內(nèi)的上方，下方，鼻側(cè)，顳側(cè)的視網(wǎng)膜厚度值。采用SPSS17.0軟件對檢查指標及觀察結(jié)果與患者的最佳矯正視力進行分析研究。 結(jié)果1、DME患者視力和黃斑9個分區(qū)的視網(wǎng)膜厚度均有一定的負相關(guān)性（-0.232—-0.416），各個分區(qū)的相關(guān)性不一；2、DME患者和黃斑中心凹厚度（CPT）有明顯的負相關(guān)（r=-0.311,P=0.004）；3、DME患者黃斑區(qū)視網(wǎng)膜IS/OS連接的分級與視力之間的關(guān)系顯示為高度負相關(guān)（相關(guān)系數(shù)r=-0.620， P=0.000）。即：IS/OS連接的分級越高（破壞范圍越廣），則患眼的視力越差；4、不同級別之間的患眼視力以及不同視力組之間的分級比較均有顯著性差異。5、DME患者黃斑中心凹厚度（CPT）與IS/OS連接的分級亦顯著相關(guān)（r=0.436,P=0.000）,即隨著DME患者黃斑水腫區(qū)黃斑中心凹厚度值的增大，則會出現(xiàn)IS/OS破壞范圍相對應的擴大。 結(jié)論通過SD-OCT對DME患者的檢查結(jié)果提示：黃斑中心凹厚度、黃斑各個分區(qū)的視網(wǎng)膜厚度以及黃斑區(qū)視網(wǎng)膜IS/OS連接的組織形態(tài)的改變對患者的視力都有一定的關(guān)系，這對我們在臨床診斷及治療中判斷患者的視力、預后及隨訪病情變化有一定的指導意義。
[Abstract]:Objective to investigate the changes of macular retinal thickness and IS/OS junction of retinal photoreceptor in diabetic macular edema patients with diabetic macular edema by frequency-domain optical coherence tomography (SD-OCT). At the same time, the morphological changes of IS/OS connection were graded, and the relationship between the changes and the visual acuity of the patients was analyzed. Methods retrospective case study. From November 2010 to June 2011, 68 patients (126 eyes) with diabetic macular edema (diabetic macular edema,DME) were diagnosed in our hospital, including 33 males and 35 females with a mean age of 59.32 鹵9.85 years, ranging from 39-80 years. All the patients were examined with Spectralis OCT (HeidelbergEngineering, Dossenheim, Germany) to observe the morphological changes of IS/OS junction in retinal macular area. The horizontal and vertical scanning lines passing through the fovea were then manually measured to obtain the foveal thickness of the macular fovea, and the mean values of both were taken as the final fovea thickness (CPT);. The macular thickness in the central macular area of 1000um and the retinal thickness in the two diameters of the macular region of 3000umn 6000um were measured by using the macular topographic map software of the SD-OCT system. The retinal thickness of the macular 1000um was measured at the upper, lower, nasal and temporal sides. SPSS17.0 software was used to analyze the examination index, observation results and the best corrected visual acuity (BCVA) of the patients. Results (1) the visual acuity of DME patients was negatively correlated with the retinal thickness in 9 macular zones (-0.232--0.416), and the correlation was different among the 9 subzones. 2there was a significant negative correlation between (CPT) and macular foveal thickness (r-0.311P0. 004). 3There was a high negative correlation between the grade of retinal IS/OS junction and visual acuity in DME patients (r = 0.620, P = 0.000). That is, the higher the grade of IS/OS connection (the wider the range of destruction), the worse the visual acuity of the affected eyes; (4) there were significant differences in the visual acuity of the affected eyes and the grade comparison among different visual acuity groups among different grades. (5) there was also a significant correlation between the grade of macular foveal thickness (CPT) and the grade of IS/OS junction (r = 0.436, P = 0.000). With the increase of macular fovea thickness in macular edema area of DME patients, the corresponding expansion of IS/OS damage would occur. Conclusion the results of SD-OCT examination of DME patients suggest that the thickness of macular fovea, retinal thickness of various macular zones and the changes of retinal IS/OS junction in macular area are related to the visual acuity of the patients. It is helpful for us to judge the visual acuity, prognosis and follow up in clinical diagnosis and treatment.
【學位授予單位】：華中科技大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R774.5
本文編號：2397193
[Abstract]:Objective to investigate the changes of macular retinal thickness and IS/OS junction of retinal photoreceptor in diabetic macular edema patients with diabetic macular edema by frequency-domain optical coherence tomography (SD-OCT). At the same time, the morphological changes of IS/OS connection were graded, and the relationship between the changes and the visual acuity of the patients was analyzed. Methods retrospective case study. From November 2010 to June 2011, 68 patients (126 eyes) with diabetic macular edema (diabetic macular edema,DME) were diagnosed in our hospital, including 33 males and 35 females with a mean age of 59.32 鹵9.85 years, ranging from 39-80 years. All the patients were examined with Spectralis OCT (HeidelbergEngineering, Dossenheim, Germany) to observe the morphological changes of IS/OS junction in retinal macular area. The horizontal and vertical scanning lines passing through the fovea were then manually measured to obtain the foveal thickness of the macular fovea, and the mean values of both were taken as the final fovea thickness (CPT);. The macular thickness in the central macular area of 1000um and the retinal thickness in the two diameters of the macular region of 3000umn 6000um were measured by using the macular topographic map software of the SD-OCT system. The retinal thickness of the macular 1000um was measured at the upper, lower, nasal and temporal sides. SPSS17.0 software was used to analyze the examination index, observation results and the best corrected visual acuity (BCVA) of the patients. Results (1) the visual acuity of DME patients was negatively correlated with the retinal thickness in 9 macular zones (-0.232--0.416), and the correlation was different among the 9 subzones. 2there was a significant negative correlation between (CPT) and macular foveal thickness (r-0.311P0. 004). 3There was a high negative correlation between the grade of retinal IS/OS junction and visual acuity in DME patients (r = 0.620, P = 0.000). That is, the higher the grade of IS/OS connection (the wider the range of destruction), the worse the visual acuity of the affected eyes; (4) there were significant differences in the visual acuity of the affected eyes and the grade comparison among different visual acuity groups among different grades. (5) there was also a significant correlation between the grade of macular foveal thickness (CPT) and the grade of IS/OS junction (r = 0.436, P = 0.000). With the increase of macular fovea thickness in macular edema area of DME patients, the corresponding expansion of IS/OS damage would occur. Conclusion the results of SD-OCT examination of DME patients suggest that the thickness of macular fovea, retinal thickness of various macular zones and the changes of retinal IS/OS junction in macular area are related to the visual acuity of the patients. It is helpful for us to judge the visual acuity, prognosis and follow up in clinical diagnosis and treatment.
【學位授予單位】：華中科技大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R774.5
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