光学相干断层扫描在视网膜动脉阻塞疾病中的应用

发布时间：2018-05-09 01:24

本文选题：光学相干断层扫描 + 视网膜中央动脉阻塞　；参考：《石河子大学》2014年硕士论文

【摘要】：目的：探讨光学相干断层扫描在视网膜动脉阻塞疾病中的应用并分析内层视网膜厚度与患者治疗前后视力是否存在相关性。方法：收集2010年7月至2013年11月在石河子大学医学院第一附属医院住院的视网膜动脉阻塞患者27例（27只眼），其中男性患者16例，女性患者11例；年龄37岁-83岁（平均60.65岁）；右眼17例，左眼10例。其中诊断为视网膜中央动脉阻塞患者共15例（15只眼）；诊断为视网膜分支动脉阻塞患者共12例（12只眼）。收集患者发病至入院时间、初始视力、治疗后视力，采用TOPCON3D OCT-1000对患者进行黄斑OCT检查，测量黄斑区视网膜厚度，进行定量测定和分析黄斑中心凹、距中心小凹3mm及6mm上、下、鼻、颞侧扇形面积下视网膜全层的平均厚度。内层视网膜厚度采用人工手动测量。距黄斑中心小凹1mm处内层视网膜，鼻侧记为N1，颞侧记为T1，距黄斑中心小凹3mm处内层视网膜，鼻侧记为N3，颞侧记为T3。并进行统计分析，各组数据均用均数标准差(s)表示。所得实验数据两组均数的比较采用t检验，等级资料相关性采用Spearman相关分析，P0.05认为差异有统计学意义。结果：19/27的患者视力均有不同程度的提高。经过治疗后视网膜中央动脉阻塞患者的视力与初始视力相比，差异有统计学意义（P=0.0350.05）。年龄、患全身疾病情况对患者最终视力无明显影响，（P=0.0910.05）。患视网膜中央动脉阻塞眼的黄斑中心凹及鼻侧3mm扇形面积下视网膜全层厚度比对侧健眼增厚（P 0.05），余各区域面积下视网膜全层厚度与健眼相比无统计学差异（P0.05）；患眼N1、N3及T3均比健眼增厚（P 0.05）；黄斑中心凹厚度患眼与健眼的差值与治疗后视力呈负相关，，r=-0.740（P 0.05）；患眼与健眼N1、T3的差值与治疗后视力呈负相关，r(N1)=-0.692, r(T3)=-0.657（P0.05）。视网膜分支动脉阻塞各组数据比较及相关性分析，结果均无统计学意义。结论：OCT测量视网膜中央动脉阻塞患者黄斑中心凹厚度及内层视网膜厚度，发现黄斑区视网膜水肿程度与疾病预后视力之间呈负相关。OCT检查对视网膜中央动脉阻塞患者预测治疗后的视力有一定的作用。
[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.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R774.1

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