Huang Jingjing, Liu Xing, Wu Ziqiang, Lin Xiaofeng, Li Mei, Dustin Laurie, Sadda Srinivas
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Retina. 2009 Mar;29(3):340-8. doi: 10.1097/IAE.0b013e31819241d0.
To describe morphologic features of traumatic macular holes on optical coherence tomography and to correlate them with clinical findings.
Seventy-three consecutive patients diagnosed with full-thickness traumatic macular holes involving the fovea underwent complete ophthalmic evaluation followed by horizontal and vertical line scans using the Stratus optical coherence tomography. Retinal thickness at the edges of the holes, apical and basal diameters, and various clinical parameters were recorded. The approximate apical and basal areas and eccentricities of the holes were calculated. Morphologic parameters were correlated with clinical findings.
On the basis of optical coherence tomography findings, traumatic macular holes were classified into five morphologic types with varying average retinal thicknesses, apical areas, and basal areas. Patients who presented >90 days after injury had greater average retinal thickness (P = 0.03) and apex areas (P = 0.002) compared with those who presented within 90 days. Older patients developed more circular holes, i.e., less eccentricity of the apex (P = 0.04) and base (P = 0.01). Interestingly, none of the morphologic parameters investigated in the current study correlated with visual acuity. Patients who presented later in the clinical course or who had greater average retinal thicknesses tended to have better vision (P = 0.11 and P = 0.07, respectively).
Optical coherence tomography evaluation may yield important insights into the pathogenesis and clinical findings of traumatic macular holes.
描述光学相干断层扫描(OCT)下外伤性黄斑裂孔的形态学特征,并将其与临床发现相关联。
73例连续诊断为累及黄斑中心凹的全层外伤性黄斑裂孔患者接受了全面的眼科评估,随后使用Stratus光学相干断层扫描进行水平和垂直线扫描。记录裂孔边缘的视网膜厚度、顶径和底径以及各种临床参数。计算裂孔的近似顶面积、底面积和偏心度。将形态学参数与临床发现相关联。
根据光学相干断层扫描结果,外伤性黄斑裂孔被分为五种形态学类型,其平均视网膜厚度、顶面积和底面积各不相同。受伤后90天以上就诊的患者与90天内就诊的患者相比,平均视网膜厚度(P = 0.03)和顶面积(P = 0.002)更大。年龄较大的患者形成的裂孔更呈圆形,即顶(P = 0.04)和底(P = 0.01)的偏心度更小。有趣的是,本研究中调查的形态学参数均与视力无关。临床病程较晚就诊或平均视网膜厚度较大的患者往往视力较好(分别为P = 0.11和P = 0.07)。
光学相干断层扫描评估可为外伤性黄斑裂孔的发病机制和临床发现提供重要见解。