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光学相干断层扫描结合功能诊断的临床应用:中心性浆液性脉络膜视网膜病变诊断及治疗效果评估中的优势与局限性

Clinical application of optical coherence tomography in combination with functional diagnostics: advantages and limitations for diagnosis and assessment of therapy outcome in central serous chorioretinopathy.

作者信息

Schliesser Joshua A, Gallimore Gary, Kunjukunju Nancy, Sabates Nelson R, Koulen Peter, Sabates Felix N

机构信息

Vision Research Center, Department of Ophthalmology, University of Missouri - Kansas City, School of Medicine, Kansas City, MO, USA.

出版信息

Clin Ophthalmol. 2014 Nov 21;8:2337-45. doi: 10.2147/OPTH.S73119. eCollection 2014.

Abstract

PURPOSE

While identifying functional and structural parameters of the retina in central serous chorioretinopathy (CSCR) patients, this study investigated how an optical coherence tomography (OCT)-based diagnosis can be significantly supplemented with functional diagnostic tools and to what degree the determination of disease severity and therapy outcome can benefit from diagnostics complementary to OCT.

METHODS

CSCR patients were evaluated prospectively with microperimetry (MP) and spectral domain optical coherence tomography (SD-OCT) to determine retinal sensitivity function and retinal thickness as outcome measures along with measures of visual acuity (VA). Patients received clinical care that involved focal laser photocoagulation or pharmacotherapy targeting inflammation and neovascularization.

RESULTS

Correlation of clinical parameters with a focus on functional parameters, VA, and mean retinal sensitivity, as well as on the structural parameter mean retinal thickness, showed that functional measures were similar in diagnostic power. A moderate correlation was found between OCT data and the standard functional assessment of VA; however, a strong correlation between OCT and MP data showed that diagnostic measures cannot always be used interchangeably, but that complementary use is of higher clinical value.

CONCLUSION

The study indicates that integrating SD-OCT with MP provides a more complete diagnosis with high clinical relevance for complex, difficult to quantify diseases such as CSCR.

摘要

目的

在确定中心性浆液性脉络膜视网膜病变(CSCR)患者视网膜的功能和结构参数时,本研究调查了基于光学相干断层扫描(OCT)的诊断如何能通过功能诊断工具得到显著补充,以及疾病严重程度和治疗结果的判定在多大程度上能从与OCT互补的诊断中受益。

方法

对CSCR患者进行前瞻性评估,采用微视野计(MP)和光谱域光学相干断层扫描(SD - OCT)来确定视网膜敏感度功能和视网膜厚度作为结果指标,同时测量视力(VA)。患者接受了包括针对炎症和新生血管的局部激光光凝或药物治疗在内的临床护理。

结果

以功能参数、视力和平均视网膜敏感度以及结构参数平均视网膜厚度为重点的临床参数相关性表明,功能测量在诊断能力方面相似。在OCT数据与视力的标准功能评估之间发现了中度相关性;然而,OCT与MP数据之间的强相关性表明,诊断措施并非总是可以互换使用,而是互补使用具有更高的临床价值。

结论

该研究表明,将SD - OCT与MP相结合可为诸如CSCR等复杂且难以量化的疾病提供具有高临床相关性的更完整诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9c8/4247136/c97fceaedeb7/opth-8-2337Fig1.jpg

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