视网膜静脉阻塞并发黄斑水肿的眼底造影及光学相干断层扫描特点

目的 分析视网膜静脉阻塞(RVO)并发黄斑水肿(ME)的荧光素眼底血管造影(FA)和光学相干断层扫描(OCT)特点,为RVO的ME临床诊治提供依据。方法 对75例75眼RVO患者行最佳矫正视力检查、裂隙灯、眼底镜检查、眼底彩色照相、FA、OCT检查,了解ME的FA和OCT表现类型及其对应关系,并分析FA和OCT表现类型与视力的关系。结果 75眼RVO患者中共发生ME 56眼,发生率为74.7%,ME的发生率与患者性别、年龄无关。ME常见FA 3型和OCT 2型。FA 1型患者视力最佳,而OCT 4型患者视力最差。FA类型与OCT类型存在一定的对应关系,FA 1型通常表现为OCT 1型,而FA 3型通常表现为OCT 2型,FA 4型与OCT类型无确切对应关系。OCT所测黄斑中心视网膜厚度与logMAR视力呈正相关(R2=0.322,P=0.001)。结论 RVO并发的ME以囊样水肿为主。不同类型的FA和OCT以及OCT所测黄斑中心视网膜厚度与患者视力存在相关性。OCT类型与FA类型有一定对应关系,但OCT显示的囊样水肿不能区分是否缺血,治疗前需要结合FA和OCT对RVO的ME进行更精确的分类。
Objective To analyze the characteristics of fluorescein angiography (FA) and optical coherence tomography (OCT) of macular edema (ME) secondary to retinal vein occlusion (RVO), so as to provide evidence for the clinical management of RVO. Methods Totally 75 RVO patients (75 eyes) underwent best corrected visual acuity (BCVA), funduscopy, fundus photography, FA and OCT examination. The correspondence between FA findings and OCT findings for ME and their relationship with BCVA were analyzed. Results It was found that ME occurred in 56 of the 75 eyes. The occurrence of ME was irrelevant to gender and age. Retinal thickness of the central fovea of macula was positively related to logMAR vision(R2=0.322,P=0.001). ME types were mostly FA type 3 and OCT type 2. The vision of FA type 1 was the best and that of OCT type 4 was the worst. There was a certain correspondence between FA type and OCT type: with OCT type 1 usually manifested as FA type 1 and OCT type 2 usually as FA type 3,and FA type 4 had no correspondence to a certain OCT type. Conclusion Cystic macular edema is the main presentation of ME secondary to RVO. Different FA types, OCT types and central fovea thickness reflect different visual acuity. There is a certain correspondence between FA types and OCT types, but OCT can not identify ischemia in cystic macular edema. A combination of FA and OCT may help to further distinguish different types of ME before treatment