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糖尿病性黄斑水肿中光学相干断层扫描与荧光素血管造影结果的相关性

Correlation between optical coherence tomography and fluorescein angiography findings in diabetic macular edema.

作者信息

Otani Tomohiro, Kishi Shoji

机构信息

Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Japan.

出版信息

Ophthalmology. 2007 Jan;114(1):104-7. doi: 10.1016/j.ophtha.2006.06.044. Epub 2006 Oct 27.

DOI:10.1016/j.ophtha.2006.06.044
PMID:17070586
Abstract

OBJECTIVE

To report the relationship between the findings of third-generation optical coherence tomography (OCT) and fluorescein angiography (FA) in eyes with diabetic macular edema (DME).

DESIGN

Small case series.

PARTICIPANTS

Four eyes with DME.

METHODS

We compared findings from late-phase FA with corresponding cross-sectional OCT images using 5-mm-long horizontal and vertical scans.

MAIN OUTCOME MEASURES

Fluorescein angiography and OCT findings in DME.

RESULTS

Fluorescein angiography showed dye pooling within the cystic spaces with a petalloid pattern in the foveal area in all eyes; 3 eyes had cystic spaces primarily in the outer plexiform layer (OPL) on OCT. In 16 perifoveal areas in 4 eyes, FA showed hyperfluorescence with a honeycomb pattern in 7 areas, petalloid pattern in 3, and diffuse pattern in 3. The remaining 3 perifoveal areas had no hyperfluorescence. Optical coherence tomography showed that the perifoveal areas with a honeycomb pattern of hyperfluorescence had not only swelling of the OPL but also cystoid spaces located in the inner nuclear layer (INL). The perifoveal areas with no honeycomb pattern but petalloid or diffuse hyperfluorescence had only retinal swelling of the OPL. In the remaining 3 perifoveal areas without hyperfluorescence, OCT showed almost normal retinal structures.

CONCLUSIONS

Diabetic macular edema typically showed 2 patterns of dye pooling on late-phase FA (i.e., petalloid in the fovea and honeycomb in the perifoveal area). The dye pooling corresponded to large cystic spaces in the OPL, and the honeycomb pattern to small cystic spaces in the INL.

摘要

目的

报告糖尿病性黄斑水肿(DME)患者眼内第三代光学相干断层扫描(OCT)与荧光素血管造影(FA)检查结果之间的关系。

设计

小型病例系列。

研究对象

4例患有DME的眼。

方法

我们使用5毫米长的水平和垂直扫描,将晚期FA的检查结果与相应的OCT横断面图像进行比较。

主要观察指标

DME患者的荧光素血管造影和OCT检查结果。

结果

荧光素血管造影显示,所有患眼中黄斑区囊样间隙内均有染料积存,呈花瓣样形态;3只眼在OCT上显示囊样间隙主要位于外丛状层(OPL)。在4只眼的16个黄斑旁区域中,FA显示7个区域呈蜂窝样高荧光,3个区域呈花瓣样,3个区域呈弥漫样。其余3个黄斑旁区域无高荧光。光学相干断层扫描显示,呈蜂窝样高荧光的黄斑旁区域不仅有OPL肿胀,而且在内核层(INL)有囊样间隙。无蜂窝样形态但呈花瓣样或弥漫样高荧光的黄斑旁区域仅有OPL视网膜肿胀。在其余3个无高荧光的黄斑旁区域,OCT显示视网膜结构几乎正常。

结论

糖尿病性黄斑水肿在晚期FA上通常表现为2种染料积存形态(即黄斑区呈花瓣样,黄斑旁区域呈蜂窝样)。染料积存对应于OPL中的大囊样间隙,而蜂窝样形态对应于INL中的小囊样间隙。

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