本文選題：光學相干斷層掃描 + 視網膜中央動脈阻塞��； 參考：《石河子大學》2014年碩士論文

【摘要】：目的：探討光學相干斷層掃描在視網膜動脈阻塞疾病中的應用并分析內層視網膜厚度與患者治療前后視力是否存在相關性。 方法：收集2010年7月至2013年11月在石河子大學醫(yī)學院第一附屬醫(yī)院住院的視網膜動脈阻塞患者27例（27只眼），其中男性患者16例，女性患者11例；年齡37歲-83歲（平均60.65歲）；右眼17例，左眼10例。其中診斷為視網膜中央動脈阻塞患者共15例（15只眼）；診斷為視網膜分支動脈阻塞患者共12例（12只眼）。收集患者發(fā)病至入院時間、初始視力、治療后視力，采用TOPCON3D OCT-1000對患者進行黃斑OCT檢查，測量黃斑區(qū)視網膜厚度，進行定量測定和分析黃斑中心凹、距中心小凹3mm及6mm上、下、鼻、顳側扇形面積下視網膜全層的平均厚度。內層視網膜厚度采用人工手動測量。距黃斑中心小凹1mm處內層視網膜，鼻側記為N1，顳側記為T1，距黃斑中心小凹3mm處內層視網膜，鼻側記為N3，顳側記為T3。并進行統(tǒng)計分析，各組數(shù)據(jù)均用均數(shù)標準差(s)表示。所得實驗數(shù)據(jù)兩組均數(shù)的比較采用t檢驗，等級資料相關性采用Spearman相關分析，P0.05認為差異有統(tǒng)計學意義。 結果：19/27的患者視力均有不同程度的提高。經過治療后視網膜中央動脈阻塞患者的視力與初始視力相比，差異有統(tǒng)計學意義（P=0.0350.05）。年齡、患全身疾病情況對患者最終視力無明顯影響，（P=0.0910.05）�；家暰W膜中央動脈阻塞眼的黃斑中心凹及鼻側3mm扇形面積下視網膜全層厚度比對側健眼增厚（P 0.05），余各區(qū)域面積下視網膜全層厚度與健眼相比無統(tǒng)計學差異（P0.05）；患眼N1、N3及T3均比健眼增厚（P 0.05）；黃斑中心凹厚度患眼與健眼的差值與治療后視力呈負相關，，r=-0.740（P 0.05）；患眼與健眼N1、T3的差值與治療后視力呈負相關，r(N1)=-0.692, r(T3)=-0.657（P0.05）。視網膜分支動脈阻塞各組數(shù)據(jù)比較及相關性分析，結果均無統(tǒng)計學意義。 結論：OCT測量視網膜中央動脈阻塞患者黃斑中心凹厚度及內層視網膜厚度，發(fā)現(xiàn)黃斑區(qū)視網膜水腫程度與疾病預后視力之間呈負相關。OCT檢查對視網膜中央動脈阻塞患者預測治療后的視力有一定的作用。
[Abstract]:Objective: to investigate the application of optical coherence tomography (OCT) in the diagnosis of retinal artery occlusion and to analyze the correlation between the thickness of the inner retina and the visual acuity of the patients before and after treatment. Methods: from July 2010 to November 2013, 27 patients with retinal artery occlusion were collected from the first affiliated Hospital of Shihezi University Medical College, including 16 male and 11 female. The age ranged from 37 to 83 years (mean 60.65 years), right eye 17 cases, left eye 10 cases. 15 eyes were diagnosed as central retinal artery occlusion and 12 eyes were diagnosed as retinal branch artery occlusion. The time from onset to admission, initial visual acuity and visual acuity after treatment were collected. Macular OCT was performed with TOPCON3D OCT-1000, retinal thickness in macular area was measured, and macular fovea was quantitatively measured and analyzed. The distance between 3mm and 6mm was analyzed. The average thickness of the whole layer of the retina under the nasal and temporal fan-shaped area. The thickness of the inner retina was measured manually. The inner retina of 1mm from central fovea of macular, nasal side is N 1, temporal side is T 1, internal layer retina of 3mm from central fovea of macula, nasal side is N 3, temporal side is T 3. Statistical analysis was carried out, and the data of each group were expressed by mean standard deviation (s). T test was used to compare the mean of the two groups of experimental data, and the correlation of grade data was analyzed by Spearman correlation analysis (P0.05). The results showed that percent of the 19 / 27 patients improved their eyesight to varying degrees. After treatment, the visual acuity of the patients with central retinal artery occlusion was significantly different from that of the initial visual acuity. Age, systemic disease had no significant effect on the final visual acuity of the patients. The thickness of the whole retinal layer in the macular fovea and nasal 3mm fan area in the eyes with central retinal artery occlusion was higher than that in the normal eyes (P 0.05), but there was no significant difference in the thickness of the whole retinal layer between the other areas and the normal eyes (P 0.05). The difference between the thickness of macular fovea and normal eyes was negatively correlated with the visual acuity after treatment, and the difference between N1T 3 and N1T 3 was negatively correlated with the visual acuity after treatment, and there was a negative correlation between the difference of T 3 and the visual acuity after treatment, and the difference between the thickness of macular fovea and that of normal eyes was negatively correlated with the visual acuity after treatment. There was no significant difference between the data of each group and the correlation analysis. Conclusion the macular fovea thickness and inner retinal thickness in patients with central retinal artery occlusion were measured by Oct. It was found that the degree of retinal edema in macular area was negatively correlated with the prognosis of the disease. Oct had a certain role in predicting the visual acuity after treatment in patients with central retinal artery occlusion.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R774.1

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