光学相干断层扫描在糖尿病性黄斑水肿患者中的临床应用研究
发布时间：2018-12-31 22:26
【摘要】：目的通过采用频域光学相干断层扫描仪检查（SD-OCT）来观察糖尿病性黄斑水肿患者的黄斑区视网膜厚度和黄斑区视网膜光感受器细胞层IS/OS连接的变化，同时对IS/OS连接的形态改变进行分级，并分析其变化与患者视力的关系。 方法回顾性病例研究。对2010年11月至2011年6月于我院确诊为糖尿病性黄斑水肿(diabetic macular edema，DME)的患者68例（126只眼），，其中男33例，女35例，年龄跨度为39-80岁，平均年龄59.32±9.85岁。患者均应用Spectralis OCT (HeidelbergEngineering, Dossenheim, Germany)进行检查，观察视网膜黄斑区IS/OS连接的形态学变化；然后对经过黄斑中心凹所做的水平及垂直扫描线进行手动测量以获得黄斑中心凹厚度值，并取两者的平均值作为最终的黄斑中心凹厚度（CPT）；进一步应用SD-OCT系统自带的黄斑地形图软件分析测量黄斑部1000um的黄斑中心区视网膜厚度,以及黄斑部3000um,6000um的两个直径范围内的上方，下方，鼻侧，颞侧的视网膜厚度值。采用SPSS17.0软件对检查指标及观察结果与患者的最佳矫正视力进行分析研究。 结果1、DME患者视力和黄斑9个分区的视网膜厚度均有一定的负相关性（-0.232—-0.416），各个分区的相关性不一；2、DME患者和黄斑中心凹厚度（CPT）有明显的负相关（r=-0.311,P=0.004）；3、DME患者黄斑区视网膜IS/OS连接的分级与视力之间的关系显示为高度负相关（相关系数r=-0.620， P=0.000）。即：IS/OS连接的分级越高（破坏范围越广），则患眼的视力越差；4、不同级别之间的患眼视力以及不同视力组之间的分级比较均有显著性差异。5、DME患者黄斑中心凹厚度（CPT）与IS/OS连接的分级亦显著相关（r=0.436,P=0.000）,即随着DME患者黄斑水肿区黄斑中心凹厚度值的增大，则会出现IS/OS破坏范围相对应的扩大。 结论通过SD-OCT对DME患者的检查结果提示：黄斑中心凹厚度、黄斑各个分区的视网膜厚度以及黄斑区视网膜IS/OS连接的组织形态的改变对患者的视力都有一定的关系，这对我们在临床诊断及治疗中判断患者的视力、预后及随访病情变化有一定的指导意义。
[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 卤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.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R774.5
本文编号：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 卤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.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R774.5
【参考文献】
相关期刊论文 前4条
1 张玮;山本香织;堀贞夫;;糖尿病黄斑水肿玻璃体手术治疗1a预后(英文)[J];国际眼科杂志;2005年06期
2 郭凯;韩萍;;糖尿病性黄斑水肿的研究进展[J];国际眼科杂志;2007年02期
3 王海欣;张卯年;;糖尿病黄斑水肿的早期诊断和治疗[J];国外医学(眼科学分册);2005年06期
4 张美霞,杨兰芬,罗成仁,严密,孟丹,沈齐,杜彩凤;糖尿病视网膜病变黄斑水肿的临床分析[J];中华眼底病杂志;2003年02期
本文编号：2397193
本文链接：https://www.wllwen.com/yixuelunwen/wuguanyixuelunwen/2397193.html
最近更新
教材专著
