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目的 观察引起黄斑下脉络膜新生血管 (CNV)的几种常见疾病的光相干断层扫描 (OCT)图像特征并对其分类 ,为 CNV的鉴别诊断和治疗提供依据。 方法 回顾分析经常规眼底检查以及荧光素眼底血管造影 (FFA)检查确诊的老年性黄斑变性 (AMD)、病理性近视、中心性渗出性脉络膜视网膜炎(CEC)和特发性脉络膜新生血管 (ICNV)患者 16 5例 187只眼的 OCT检查资料 ,结合 FFA检查结果对OCT图像进行分类并总结分析各类图像特征。 结果 可确定边界的 CNV6 0只眼 ,表现为边界清楚的视网膜色素上皮 (RPE)层和脉络膜毛细血管层的梭形增厚 ;不易确定边界的 CNV10 1只眼 ,表现为弥散的脉络膜反向散射增强 ;浆液性 RPE脱离 19只眼 ,表现为 RPE下的光学暗区 ;出血性 RPE脱离 11只眼 ,表现为 RPE下的高反向散射区域 ,迅速衰减 ;纤维血管性 RPE脱离 10只眼 ,表现为 RPE和脉络膜之间的轻至中度无反向散射区 ;神经上皮脱离 4 5只眼 ,表现为神经上皮层与 RPE分离 ,其间为光学暗区。 结论 引起黄斑下 CNV的几种常见疾病的 OCT图像可以分为 6类 ,分析 OCT的图像特征有助于 CNV的鉴别诊断与治疗。
Objective To observe and classify the features of several common diseases caused by sub-macular choroidal neovascularization (CNV) and provide a basis for the differential diagnosis and treatment of CNV. Methods Retrospective analysis of conventional macular fundus examination and fluorescein angiography (FFA) examination confirmed age-related macular degeneration (AMD), pathological myopia, central exudative chorioretinitis (CEC) and idiopathic choroidal neovascularization ICNV) patients with 165 eyes 187 cases of OCT examination data, combined with the results of FFA OCT images were classified and summarized analysis of various types of image features. RESULTS: Sixty CNVs at the borderline were identified, showing a fusiform thickening of the RPE and choriocapillaris layers at the border; one CNV10 at the border was not easily identifiable as diffuse choroidal backscatter Enhanced serous RPE detachment in 19 eyes, the performance of optical dark area under RPE; hemorrhagic RPE detachment in 11 eyes, showing high backscatter area under RPE, rapidly decay; fibrovascular RPE from 10 eyes, Reflected from the RPE and the choroid between the light and moderate non-backscattering zone; neuroepithelial detachment of 45 eyes, the performance of the neural epithelium and RPE separation, in which the optical dark area. Conclusion OCT images of several common diseases causing CNV under the macula can be divided into six categories. Analyzing the OCT image features is helpful for the differential diagnosis and treatment of CNV.