Duke University Eye Center, Department of Ophthalmology, Duke University, Durham, North Carolina.
Duke University Eye Center, Department of Ophthalmology, Duke University, Durham, North Carolina.
Am J Ophthalmol. 2014 May;157(5):978-84. doi: 10.1016/j.ajo.2014.01.021. Epub 2014 Jan 31.
To evaluate the impact of different scan patterns and scan densities on small full-thickness macular hole (MH) detection.
Retrospective cross-sectional analysis.
Analysis was performed on 25 eyes from 24 patients with full-thickness MHs imaged with the Heidelberg Spectralis HRA+OCT. Included eyes underwent concurrent imaging with a standard (61-line) raster volume and a 24-line radial pattern. A 6-line radial scan pattern was extrapolated from the higher-density radial pattern. Comparisons of the missed hole rate as well as the proportion of individual B-scans demonstrating a full-thickness defect (termed "full-thickness detection index") were carried out for the 3 scan patterns. Additionally, qualitative and quantitative hole parameters were evaluated to identify factors associated with "missed" holes.
Full-thickness defects were missed at substantially higher rates using both standard raster volume (20.0%, 90% confidence interval [CI] 8.2%-37.5%) and 6-line radial scanning (12.0%, 90% CI 3.7%-30.4%) when compared to 24-line radial scanning (0% for both comparisons). Full-thickness detection indices were significantly higher for both radial scan patterns when compared to raster scanning (P < .001 for both comparisons). Missed holes were smaller and commonly associated with prehole flaps.
High-density radial scanning demonstrated superior detection rates of small full-thickness MHs compared to standard raster volume scanning. This finding may be attributable to the greater foveolar scan density attained with radial scan patterns. Failure to utilize radial scanning in the setting of suspected macular holes may lead to a delay in surgical treatment, with attendant worse anatomic and visual outcomes.
评估不同扫描模式和扫描密度对小全层黄斑裂孔（MH）检测的影响。
回顾性横断面分析。
对 24 例 25 只全层 MH 患者的海德堡 Spectralis HRA+OCT 图像进行分析。纳入的眼同时进行标准（61 线）光栅体积和 24 线放射状模式成像。从较高密度的放射状模式推断出 6 线放射状扫描模式。对 3 种扫描模式的漏孔率以及个别 B 扫描显示全层缺损的比例（称为“全层检测指数”）进行比较。此外，还评估了定性和定量的孔参数，以确定与“漏孔”相关的因素。
与 24 线放射状扫描相比，标准光栅体积（20.0%，90%置信区间[CI]8.2%-37.5%）和 6 线放射状扫描（12.0%，90%CI3.7%-30.4%）的全层缺损漏诊率显著更高。与光栅扫描相比，两种放射状扫描模式的全层检测指数均显著更高（两种比较均 P <.001）。漏诊的孔更小，通常与孔前瓣有关。
与标准光栅体积扫描相比，高密度放射状扫描显示出对小全层 MH 更高的检测率。这一发现可能归因于放射状扫描模式中更密集的中心凹扫描密度。在怀疑存在黄斑裂孔的情况下未能使用放射状扫描可能导致手术治疗延迟，从而导致解剖和视觉结局更差。
