频域光学相干断层扫描黄斑光损伤表现的特点

摘要

目的 探讨频域光学相干断层扫描(fourier-domain optical coherence tomography,FD-OCT)应用于光损伤黄斑病变所表现出的特点及重要性.方法 回顾性研究.对光损伤黄斑病变7例(11只眼)进行FD-OCT检查.包括阳光导致视网膜病变2只眼,电弧光导致视网膜病变6只眼,激光损伤导致视网膜病变3只眼.所有患者均行散瞳眼底检查照相,部分患者行多焦视网膜电图检查.结果 所有患眼均有黄斑区病理改变.视力0.04 ～1.0.FD-OCT显示在视锥细胞内外节层局限性缺失7只眼,视网膜层间低反射暗腔3只眼,黄斑孔1只眼.揭示了光损伤黄斑病变缺损区域不仅存在于视细胞层,还存在于视细胞外节与色素上皮绒毛的连接处.激光损伤的黄斑病变可以表现为多种形态.结论 FD-OCT能够在不同类型光损伤黄斑病变患眼中显示出显著的形态学改变,FD-OCT更能发现视细胞外节与色素上皮绒毛连接处的特征性改变,提高了诊治效率.%Objective To investigate the morphological changes of photic maculopathy detected by fourier-domain optical coherence tomographic (FD-OCT).Methods In this retrospective study,11 eyes of 7 patients with photic maculopathy were examined by FD-OCT,including 2 eyes with solar retinopathy,6 eyes with welding arc maculopathy,and 3 eyes with laser injury.The dilated funduscopic and photographic examination were performed in all patients.Multifocal electroretinogram (mfERG) was performed in some patients.Results The foveal pathology was identified in all 11 eyes (7 patients).The visual acuity ranged from 0.04 to 1.0.FD-OCT demonstrated foveal atrophy associated with a characteristic defect at the level of the inner and outer segment junction of cone cell in 7 affected eyes,hyporeflective space beween the outer retinal and retinal pigment epithelium (RPE) layers in 3 eyes,and macular hole in 1 eye.FD-OCT even revealed the localized defect area lay not only in IS/OS layer but also in connecting of outer segment and pigment process of RPE.Conclusion FD-OCT can detect foveal morphological changes and characteristic defects at the photoreceptor-RPE junction in photic retinopathy.