本文關(guān)鍵詞： 眼鈍挫傷 外傷性黃斑裂孔 視網(wǎng)膜震蕩 視網(wǎng)膜下出血 光學(xué)相干斷層掃描　出處：《汕頭大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:研究外傷性視網(wǎng)膜病變的頻域OCT圖像特征和類型,從而更好的指導(dǎo)臨床診斷以及探索其發(fā)病機(jī)制。 方法:本研究為回顧性研究。研究對象為汕頭大學(xué)·香港中文大學(xué)聯(lián)合汕頭國際眼科中心(JSIEC)就診的外傷性視網(wǎng)膜病變患者。對JSIEC的門診數(shù)據(jù)庫和頻域OCT數(shù)據(jù)庫進(jìn)行檢索,測量和分析患者的OCT檢查結(jié)果。 結(jié)果:本研究納入外傷性視網(wǎng)膜病變的患者有138例(138眼),在頻域OCT上表現(xiàn)出的外傷性視網(wǎng)膜病變主要有以下幾種:1)外傷性黃斑裂孔25例;2)視網(wǎng)膜下出血30例;3)脈絡(luò)膜破裂32例;4)視網(wǎng)膜萎縮70例;5)內(nèi)界膜皺褶19例;6)視網(wǎng)膜色素上皮撕裂2例。根據(jù)OCT將外傷性黃斑裂孔分為伴孔周視網(wǎng)膜囊樣水腫和不伴囊樣水腫兩種類型,不伴發(fā)囊樣水腫組多合并有視網(wǎng)膜萎縮或者視網(wǎng)膜下出血(P0.001),且視力較差(1.18 vs 0.87,P=0.077)。中心凹下出血較周邊部出血年齡大(30.5 vs 21.7歲,P=0.026),而且出血范圍較局限(1.7 vs 3.6視盤直徑,P=0.001);脈絡(luò)膜破裂32例中有26例(81%)合并脈絡(luò)膜新生血管,其中僅有1例(3%)伴有視網(wǎng)膜下或者網(wǎng)膜內(nèi)滲出。視網(wǎng)膜震蕩主要引起外層視網(wǎng)膜病變,可以分為4種不同的嚴(yán)重程度,嚴(yán)重程度與最佳矯正視力呈正相關(guān)(相關(guān)系數(shù)0.528,P0.001),與中心凹視網(wǎng)膜厚度呈負(fù)相關(guān)(相關(guān)系數(shù)-0.521,P0.001)。部分患者還可以發(fā)生內(nèi)層視網(wǎng)膜高反射信號(hào)/內(nèi)層視網(wǎng)膜萎縮、內(nèi)界膜皺褶、視網(wǎng)膜色素上皮撕裂等病變。發(fā)生兩種或兩種以上視網(wǎng)膜病變類型患者共有47例(34%)。 結(jié)論:OCT可以將外傷性黃斑裂孔分為伴發(fā)孔周視網(wǎng)膜囊樣水腫和不伴有視網(wǎng)膜水腫兩類,后者多伴有視網(wǎng)膜萎縮或者視網(wǎng)膜下出血。中心凹較周邊部視網(wǎng)膜下出血較為局限。OCT可以將視網(wǎng)膜震蕩分為四級(jí)不同的嚴(yán)重程度,分級(jí)與LogMAR最佳矯正視力呈正相關(guān),與中心凹視網(wǎng)膜厚度成負(fù)相關(guān)。眼鈍挫傷還可以引起內(nèi)層視網(wǎng)膜萎縮、色素上皮撕裂等病變。頻域OCT有更高的敏感度,可發(fā)現(xiàn)細(xì)微的病變,而且可以定量測量,在外傷性視網(wǎng)膜病變的診斷和病情判斷中具有重要的價(jià)值。
[Abstract]:Objective: to study the characteristics and types of OCT images of traumatic retinopathy in order to guide clinical diagnosis and explore its pathogenesis. Methods: this study was a retrospective study. The subjects were the patients with traumatic retinopathy treated by Shantou University, Chinese University of Hong Kong and Shantou International Ophthalmology Center. The outpatient database and frequency-domain OCT database of JSIEC were searched. OCT findings were measured and analyzed. Results: in this study, 138 patients (138 eyes) with traumatic retinopathy were included. In frequency domain OCT, the main types of traumatic retinopathy were as follows: 1) 25 cases of traumatic macular hole (n = 25)) 30 cases of subretinal hemorrhage (n = 30). Choroidal rupture (n = 32) Retinal atrophy (n = 70) (n = 70) inner boundary membrane fold (n = 19)) retinal pigment epithelium tear (n = 2). According to OCT, traumatic macular holes were divided into two types: retinal cystoid edema with hole and without cystic edema. In the group without cystic edema, retina atrophy or subretinal hemorrhage was associated with P0.001, and the visual acuity was poor 1.18 vs 0.87g / P 0.077. The age of intracentric hemorrhage was 30.5 vs 21.7 years old, and the range of hemorrhage was limited to 1.7 vs 3.6 optic disc diameter. Choroidal neovascularization was found in 26 of 32 cases of choroidal rupture. There is only one case with subretinal or intraretinal exudation. Retinal concussion mainly causes outer retinopathy, which can be divided into four different degrees of severity. The severity was positively correlated with the best corrected visual acuity (correlation coefficient: 0.528, P 0.001), and negatively correlated with the thickness of the fovea retina (correlation coefficient -0.521, P 0.001). Some patients also had hyperreflex signal / retinal atrophy in the inner layer of retina, and a wrinkle in the inner boundary membrane, and a negative correlation was found between the degree of severity and the thickness of the fovea retina. There were 47 patients with two or more types of retinopathy. Conclusion the traumatic macular holes can be classified into two groups by using Oct: retinal cystic edema with or without retinal edema. The concave is more limited than the peripheral subretinal hemorrhage. Oct can divide the concussion into four levels of severity, and the grade is positively correlated with the best corrected visual acuity of LogMAR. Blunt eye contusion can also cause retinal atrophy in the inner layer, laceration of pigment epithelium, etc. Frequency domain OCT has higher sensitivity, can detect subtle lesions, and can be measured quantitatively. It has important value in the diagnosis and diagnosis of traumatic retinopathy.
【學(xué)位授予單位】：汕頭大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R774.1

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本文編號(hào)：1518149