结膜良性增生性疾病的光学相干断层扫描特征

摘要

Objective: To use anterior segment optical coherence tomography (AS-OCT) for structural imaging and accurate measurements of pinguecula and pterygium in order to understand the structural features of these lesions. Methods: This study was a prospective parallel control study. Lateral bulbar conjunctiva of 25 cases (30 eyes) that included pinguecula (10 eyes of 8 cases), pterygium (10 eyes of 9 cases), and normal eyes (10 eyes of 8 cases), were enrolled from the Department of Ophthalmology of the Fourth Affiliated Hospital of Zhejiang Medical University from January to April 2018. The anterior segment module of an Optovue optical coherence tomography angiography (OCTA) was used for measurements. The thickness of the bulbar conjunctiva epithelium and propria tissues at sites at a distance of 0.0 mm, 0.5 mm, 1.0 mm, 1.5 mm, 2.0 mm and 2.5 mm from the scleral process were stratified within the 2.5 mm range, were measured, compared and further analyzed. The data were described by means of mean±standard deviation. Repeated measurement analysis of variance was used for comparison of each point in the group, one-way analysis of variance was used for comparison between groups. Results: Compared with normal eyes and pinguecula eyes, pterygium showed thickened epithelium in 0.5 mm point (P<0.05). In the 2.5 mm range on the nasal side, pterygium and pinguecula showed thickened subepithelium tissues (P<0.05), especially for pterygium, compared to normal eye tissue. Conclusions: AS-OCT can image microstructures in benign conjunctival proliferative diseases, resulting in accurate quantitative diagnosis and evaluation. The thickness of subepithelium tissues increases in pinguecula and pterygium.%目的:应用眼前节光学相干断层扫描(AS-OCT)对睑裂斑和翼状胬肉进行结构成像和厚度测量,以了解病变的结构特征.方法:病例对照研究.利用Optovue光学相干断层扫描血管造影仪(OCTA)的前节模块对2018年1-4月就诊于浙江大学医学院附属第四医院眼科的25例(30眼)研究对象进行鼻侧球结膜成像,根据诊断分成睑裂斑组8例(10眼)、翼状胬肉组9例(10眼)和正常眼组8例(10眼).分层测量距离巩膜突0.0、0.5、1.0、1.5、2.0、2.5 mm 6个位点结膜上皮层和固有层组织的厚度.组内各位点比较采用重复测量方差分析,组间比较采用单因素方差分析.结果:与正常眼组和睑裂斑组相比,翼状胬肉组在0.5 mm处结膜上皮层明显增厚(P<0.05),其余位点差异无统计学意义.在鼻侧2.5 mm范围内,与正常眼组相比,翼状胬肉组和睑裂斑组的固有层均增厚(P<0.05),尤以胬肉组织增厚程度明显(P<0.05).结论:AS-OCT可清晰成像结膜良性增生性疾病眼的结膜组织结构,并可进行较为精准的定量诊断和评估.翼状胬肉和睑裂斑以固有层增厚为主.