白内障术前B超与频域OCT检查黄斑区图像的对照研究

摘要

AIM: To analyze the accurate diagnosis of macular diseases by B-scan ultrasound with the help of SD-OCT which can provide the theory basis for prediction of visual function of postoperative cataract surgery. METHODS:Posterior segment lesion of cataract patients can be primarily understood by B-scan ultrasound.OCT can be performed to further diagnose if there is abnormal echo in macular area. RESULTS: A total of 178 cataract patients ( 217 eyes ) who were suspected as macular diseases were examined by B-scan ultrasound and were scanned by OCT.A total of 213 eyes were diagnosed as maculopathy, including 70 eyes with wet age-related macular degeneration ( AMD) , 65 eyes with macular epiretinal membrane, 21 eyes with macular hole, 17 eyes with dry AMD and other 23 eyes with macular diseases.Results of frequency domain in 4 eyes showed that there were other lesions in the posterior pole in non-macular area.The fundus of 17 eyes can't be seen by OCT scan. These 17 eyes were diagnosed as maculopathy by SD -OCT of frequency domain after cataract operation. CONCLUSION: B-scan ultrasound can be important detection tool to understand the posterior segment lesion since most cataract patients'ocular fundus are not clear. As B type ultrasound operation is simple, inexpensive and widely used for examination with a low degree of patients'cooperation and no influences from opacity of optical media, it is often used as routine examine method before cataract surgery.If B-scan ultrasound examination shows signs of macular diseases, SD-OCT will be taken.The results of these two methods are quite constant.%目的：参照频域光相干断层扫描（频域OCT ）分析B超对诊断白内障患者黄斑病变的准确性，从而为预测白内障术后视功能提供理论依据。　　方法：通过B超来初步了解白内障患者的眼后段情况，如发现黄斑区回声有异常，可继续行频域 OCT 来进一步确诊。　　结果：术前进行B超检查怀疑有黄斑病变的白内障患者178例217眼，进一步行频域OCT扫描。有213眼确诊有黄斑病变，其中湿型年龄相关性黄斑变性（AMD）70眼，黄斑前膜65眼，黄斑裂孔21眼，干型AMD 17眼，其他黄斑病变23眼，4眼频域OCT扫描显示为非黄斑区的后极部的其他病变。 OCT完全扫描不到眼底的17眼，此17眼在行白内障手术后进行频域OCT检查均确诊为黄斑病变。结论：多数白内障患者无法看清眼底，B超就成为了解眼球后段的重要检查手段。因B超操作简单价格低廉，检查范围广，对患者的配合程度要求较低，且不受屈光间质混浊的影响，所以普遍作为白内障术前的常规检查之一。当B超显示怀疑有黄斑病变时再进一步行频域OCT扫描，二者的诊断相符性极高。