Department of Ophthalmology, University of California San Diego, Shiley Eye Center, 0946, Joan and Irwin Jacobs Retina Center, 9415 Campus Point Drive, La Jolla, CA 92037, USA.
Retina. 2010 Mar;30(3):383-9. doi: 10.1097/IAE.0b013e3181cd4803.
The purpose of this study was to determine the morphologic patterns of angiographic macular edema using simultaneous colocalization of fluorescein angiography and spectral-domain optical coherence tomography (SD-OCT) images in diabetes, epiretinal membrane, uveitic and pseudophakic cystoid macular edema, and vein occlusion.
Eighty-seven consecutive patients (107 eyes) with macular edema from 5 different etiologies were imaged by simultaneous scanning laser ophthalmoscopy/OCT to study the morphologic patterns of edema on SD-OCT and then correlated/colocalized with the fluorescein angiographic patterns of leakage. Statistical analysis was done to analyze the differences in the morphologic OCT pattern by different diseases.
Spectral-domain OCT characteristics of macular edema showed a significant difference across different diseases (P = 0.037). Cystic fluid pockets were found to be more commonly seen in patients with diabetic macular edema and retinal vein occlusions, whereas those cases with macular edema secondary to epiretinal membrane showed noncystic changes on OCT. Seventy of the 107 eyes had diffuse angiographic leakage, and the remaining 37 eyes had cystoid leakage on angiography. Of the 70 eyes with diffuse leakage, 24.28% showed microcysts on SD-OCT in the area of edema, and 70% eyes had diffuse thickening or distorted architecture without cyst. All 37 eyes with cystoid leakage showed cysts in the area of edema by SD-OCT. A total of 3.73% of eyes with fluorescein angiographic leakage had no abnormalities on SD-OCT.
Eyes with diabetic macular edema and retinal vein occlusions have a significantly higher incidence of cyst formation on SD-OCT. There was no correlation between visual acuity and cyst formation. Diffuse noncystoid angiographic macular edema may show microcysts on SD-OCT, but diffuse edema is more commonly associated with thickening or distortion of the retinal layers without cyst formation. Cystoid leakage on fluorescein angiography is always associated with cystic changes on SD-OCT.
本研究旨在通过共焦激光扫描检眼镜/光学相干断层扫描（OCT）同步扫描，确定糖尿病性、视网膜前膜性、葡萄膜炎性和后发性白内障性以及静脉阻塞性黄斑水肿的造影黄斑水肿的形态学模式。
对 5 种不同病因引起黄斑水肿的 87 例连续患者（107 只眼）进行共焦激光扫描检眼镜/OCT 同步扫描，研究 OCT 上水肿的形态学模式，并与荧光素血管造影渗漏模式相关/共定位。通过不同疾病对 OCT 形态模式的差异进行统计学分析。
不同疾病黄斑水肿的光谱 OCT 特征存在显著差异（P = 0.037）。在糖尿病性黄斑水肿和视网膜静脉阻塞患者中发现囊状液袋更为常见，而在由视网膜前膜引起的黄斑水肿患者中，OCT 显示为非囊状改变。107 只眼中 70 只眼有弥漫性造影渗漏，其余 37 只眼有囊样渗漏。在 70 只弥漫性渗漏眼中，24.28%的水肿区在 SD-OCT 上显示微囊，70%的眼有弥漫性增厚或无囊的扭曲结构。所有 37 只出现囊样渗漏的眼在 SD-OCT 上均显示水肿区有囊。在 SD-OCT 上，有 3.73%的荧光素血管造影渗漏眼无异常。
糖尿病性黄斑水肿和视网膜静脉阻塞患者 SD-OCT 上囊形成的发生率明显较高。视力与囊形成无相关性。弥漫性非囊状造影黄斑水肿在 SD-OCT 上可能显示微囊，但弥漫性水肿更常见于无囊形成的视网膜层增厚或扭曲。荧光素血管造影上的囊样渗漏总是与 SD-OCT 上的囊状改变相关。
