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[光谱域光学相干断层扫描(SD-OCT)的形态学模式作为视网膜静脉阻塞所致黄斑水肿治疗的预后指标]

[Morphologic Patterns on Spectral-Domain Optical Coherence Tomography (SD-OCT) as a Prognostic Indicator in Treatment of Macular Edema Due to Retinal Vein Occlusion].

作者信息

Groneberg T, Trattnig J S, Feucht N, Lohmann C P, Maier M

机构信息

Augenklinik, Klinikum rechts der Isar, Technische Universität München.

出版信息

Klin Monbl Augenheilkd. 2016 Sep;233(9):1056-62. doi: 10.1055/s-0041-108680. Epub 2016 Feb 8.

Abstract

BACKGROUND

SD-OCT is an important tool in the diagnosis of macular oedema (ME) due to retinal vein occlusion (RVO). Its high resolution makes it possible to distinguish various morphological characteristics and differences. The aim of this study is to evaluate the correlation between morphological patterns and the development of visual acuity (VA) after intravitreal treatment of ME due to RVO.

METHODS

81 patients on intravitreal treatment (dexamethasone: n = 53/ranibizumab: n = 28) due to ME associated with branch and central retinal vein occlusion (

BRVO

n = 38/CRVO: n = 43) were retrospectively reviewed. Preoperative SD-OCT images were analysed by vitreous adhesion, epiretinal membranes, foveal contour, height of intraretinal cystoid spaces, inner and outer segment integrity and presence of subretinal fluid. The influence of these patterns on VA improvement was analysed.

RESULTS

In almost every morphological pattern, the data were highly variable. Therapy was effective, with a medium gain in VA of 9.51 letters ETDRS (dexamethasone: 9.62 letters/ranibizumab: 9.29 letters). The improvement in VA in patients with small intraretinal cystoid spaces (thickness ≤ 250 µm) was 19.44 letters ETDRS, compared to 7.23 letters ETDRS in patients with confluent cystoid spaces (p = 0.009). Patients with a convex fovea exhibited more pronounced reduction in central retinal thickness (CRT) (p = 0.004).

CONCLUSION

Analysis of OCT has concentrated on demonstrating oedema and CRT. Our data indicate that detailed OCT morphology and the size of intraretinal cystoid spaces offer important information about VA prognosis after intravitreal therapy in ME due to RVO.

摘要

背景

频域光学相干断层扫描(SD - OCT)是诊断视网膜静脉阻塞(RVO)所致黄斑水肿(ME)的重要工具。其高分辨率使得区分各种形态特征和差异成为可能。本研究的目的是评估RVO所致ME玻璃体腔内治疗后形态学模式与视力(VA)发展之间的相关性。

方法

回顾性分析81例因分支和中央视网膜静脉阻塞(BRVO:n = 38/CRVO:n = 43)相关的ME接受玻璃体腔内治疗(地塞米松:n = 53/雷珠单抗:n = 28)的患者。术前SD - OCT图像通过玻璃体粘连、视网膜前膜、黄斑轮廓、视网膜内囊样间隙高度、内外节完整性和视网膜下液的存在情况进行分析。分析这些模式对VA改善的影响。

结果

几乎在每种形态学模式中,数据都高度可变。治疗有效,VA平均提高9.51个ETDRS字母(地塞米松:9.62个字母/雷珠单抗:9.29个字母)。视网膜内囊样间隙小(厚度≤250μm)的患者VA改善为19.44个ETDRS字母,相比之下,囊样间隙融合的患者为7.23个ETDRS字母(p = 0.009)。黄斑凸起的患者视网膜中央厚度(CRT)降低更明显(p = 0.004)。

结论

OCT分析主要集中于显示水肿和CRT。我们的数据表明,详细的OCT形态学以及视网膜内囊样间隙的大小为RVO所致ME玻璃体腔内治疗后的VA预后提供了重要信息。

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