Ghazi Nicola G, Ciralsky Jessica B, Shah Syed M, Campochiaro Peter A, Haller Julia A
Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland 21287, USA.
Am J Ophthalmol. 2007 Nov;144(5):747-754. doi: 10.1016/j.ajo.2007.07.012. Epub 2007 Sep 17.
To assess the optical coherence tomography (OCT) characteristics of eyes with persistent clinically significant diabetic macular edema (PDME) after focal laser treatment, with emphasis on the vitreomacular interface (VMI) characteristics.
Prospective, observational case series.
Fifty eyes with PDME after at least one focal laser treatment were enrolled prospectively. Slit-lamp biomicroscopy, stereoscopic fundus photography, fluorescein angiography (FA), and OCT were performed for each eye. The main outcome measures included the detection rate of VMI abnormalities (VMIA) by OCT in comparison with biomicroscopy, fundus photography, and FA (traditional techniques); the relationship between VMIA and the number of focal laser sessions per eye and FA leakage pattern.
Two of 50 eyes were excluded because of incomplete data. For the remaining 48 eyes, 25 eyes (52.1%) demonstrated definite VMIA, including anomalous vitreal adhesions, epiretinal membrane (ERM), or both, and six eyes (12.5%) had questionable VMIA. OCT in general was 1.94 times more sensitive than traditional techniques combined in detecting VMIA (P = .00003). The number of focal laser sessions and diffuse FA leakage were not associated with an increased prevalence of VMIA (P = .13 and P = .47, respectively).
This study demonstrates a high prevalence of VMIA in eyes with PDME after focal laser treatment and underscores the superiority of OCT in detecting these abnormalities. OCT evaluation of eyes with PDME may be helpful in identifying VMIA, which may impact treatment selection and patient subgroup stratification.
评估局灶性激光治疗后持续性临床显著性糖尿病黄斑水肿（PDME）患眼的光学相干断层扫描（OCT）特征，重点关注玻璃体黄斑界面（VMI）特征。
前瞻性观察病例系列。
前瞻性纳入50只接受至少一次局灶性激光治疗后的PDME患眼。对每只眼睛进行裂隙灯生物显微镜检查、立体眼底照相、荧光素血管造影（FA）和OCT检查。主要观察指标包括与生物显微镜检查、眼底照相和FA（传统技术）相比，OCT检测VMI异常（VMIA）的检出率；VMIA与每只眼局灶性激光治疗次数及FA渗漏模式之间的关系。
50只眼中有2只因数据不完整被排除。对于其余48只眼，25只眼（52.1%）表现出明确的VMIA，包括异常玻璃体粘连、视网膜前膜（ERM）或两者皆有，6只眼（12.5%）有可疑的VMIA。总体而言，OCT在检测VMIA方面比传统技术联合使用敏感1.94倍（P = .00003）。局灶性激光治疗次数和弥漫性FA渗漏与VMIA患病率增加无关（分别为P = .13和P = .47）。
本研究表明局灶性激光治疗后PDME患眼中VMIA的患病率较高，并强调了OCT在检测这些异常方面的优越性。对PDME患眼进行OCT评估可能有助于识别VMIA，这可能会影响治疗选择和患者亚组分层。
