眼底检查联合OCT诊断妊高征相关产前眼底病变的临床价值

摘要

目的 探讨眼底检查联合光学相干断层扫描(OCT)在产前妊娠高血压综合征(简称妊高征)眼底病变患者中的临床价值.方法 收集2012年12月至2015年12月产前妊高征患者66例眼底检查和OCT诊断的临床资料.结果 (1)66例患者132只眼眼底检查中,其中正常眼底4只(3.03%),眼底病变Ⅰ期发生率4.54%,Ⅱ期12.12%,Ⅲ期80.31%.(2)66例患者132只眼OCT检查异常104只眼,异常比例为78.79%,其中视网膜浆液性脱离、水肿发生率55.77%,视网膜出血和视乳头水肿发生率34.85%,黄斑渗出及视神经萎缩等发生率9.38%.(2)妊高征患病程度越高,眼底改变越重,蛋白尿水平越高眼底改变越重,将眼底检查和OCT检查结果做等级相关检验,得出二者呈正相关(P=0.000).结论 对妊高征患者产前进行眼底检查和OCT检查对发现妊高征眼底病变更有效.%Objective To explore the clinical value of fundus examination combined with optical coherence tomography(OCT)in the pregnant patients with prenatal hypertensive retinopathy.Methods The clinical data of 66 cases of antenatal women with pregnant hypertensive disorders underwent fundus camera inspection and OCT diagnosis in our hospital from December 2012 to December 2015 were collected.Results(1)Of the 132 eyes in the 66 patients,normal fundus were 4(3.03%),the incidence of ocular fundus disease stage Ⅰ was 4.54%,stage Ⅱ was 12.12% and stage Ⅲ was 80.31%.(2)Of the 132 eyes in the 66 patients,OCT checked exception were 104 eyes,abnormal rate was 78.79%,the incidence rate of retinal detachment and edema was 55.77%,the incidence of retinal hemorrhage and optic disc edema was 34.85%,and the incidence of macular exudation and optic atrophy was 9.38%.(3)The higher the incidence of pregnant hypertensive disorders,the more severe the fundus change. The higher the level of proteinuria the more severe the fundus change,rank correlation test of fundus examination and OCT findings revealed a positive correlation(C=0.472,χ2=38.471,P=0.000).Conclusions The fundus examination and OCT examination were performed in antenatal women with pregnant hypertensive disorders,which is more effective to discover the ocular fundus disease.