Ehlers Justis P, Petkovsek Daniel S, Yuan Alex, Singh Rishi P, Srivastava Sunil K
Ophthalmic Surg Lasers Imaging Retina. 2015 Mar;46(3):327-32. doi: 10.3928/23258160-20150323-05.
To assess the feasibility of intraoperative OCT (iOCT) during pars plana vitrectomy with subretinal tissue plasminogen activator (tPA) injection for subretinal hemorrhage.
Eyes that underwent vitrectomy and subretinal injection of tPA were identified from the PIONEER study, a prospective clinical study assessing the feasibility and utility of iOCT in ophthalmic surgery. A microscope-mounted spectral-domain OCT system was utilized for iOCT imaging. Standardized scan protocol and image acquisition were followed for intraoperative imaging.
iOCT was successfully obtained in four of four eyes. In all cases, increased subretinal fluid was noted, with differential reflectivity visualized between the hemorrhage-tPA interface confirming appropriate localization of tPA injection. Image quality variability was significant.
iOCT can successfully be performed during pars plana vitrectomy with subretinal tPA injection. Utilizing iOCT, appropriate placement of tPA solution and corresponding retinal architectural changes were visualized.
评估在玻璃体视网膜手术中经平坦部玻璃体切除并向视网膜下注射组织型纤溶酶原激活剂(tPA)治疗视网膜下出血时进行术中光学相干断层扫描(iOCT)的可行性。
从PIONEER研究中确定接受玻璃体切除术及视网膜下注射tPA的眼睛,该前瞻性临床研究评估iOCT在眼科手术中的可行性和实用性。使用安装在显微镜上的谱域OCT系统进行iOCT成像。术中成像遵循标准化扫描方案和图像采集。
4只眼中的4只成功获得iOCT图像。在所有病例中,均观察到视网膜下液增加,在出血 - tPA界面之间可见不同的反射率,证实了tPA注射的正确定位。图像质量差异显著。
在经平坦部玻璃体切除并视网膜下注射tPA的手术过程中可以成功进行iOCT检查。利用iOCT,可以观察到tPA溶液的正确放置以及相应的视网膜结构变化。