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[伴有视神经凹陷的黄斑病变:SD-OCT的形态学标准]

[Maculopathy with optic nerve pits : Morphological criteria in SD-OCT].

作者信息

Wehrmann K, Stumpfe S, Pettenkofer M, Feucht N, Lohmann C, Maier M

机构信息

Augenklinik, Klinikum rechts der Isar, TU München, Ismaningerstrasse 22, 81675, München, Deutschland.

出版信息

Ophthalmologe. 2018 Mar;115(3):216-221. doi: 10.1007/s00347-017-0490-2.

Abstract

PURPOSE

Optic pit is a congenital anomaly with malformation similar to coloboma of the optic disc. The cause of optic pit maculopathy is controversial. We used high resolution OCT to investigate changes in the vitreoretinal and vitreopapillary transition within optic pit eyes.

METHODS

The vitreoretinal and vitreo-papillary transition of 12 eyes was accurately analyzed using SD-OCT. We registered the following criteria: liquefaction of prepapillary vitreous, papillary vitreous traction, discontinuity within the hyaloid cortex and communication spaces between pit and retinal edema.

RESULTS

Communication gaps between pit and retinal edema were identified in 8 eyes. 4 eyes had a papillary vitreous traction. 4 showed a discontinuity in the hyaloid cortex. 2 of the 12 patients showed no maculopathy in SD-OCT. Those patients had an adjacent papillary vitreous without prepapillary liquefaction. However all eyes showed vitreous liquefaction at some stage premacullary or prepapillary.

CONCLUSION

Yet the cause of optic pit maculopathy is not clearly understood. High resolution OCT imaging provides a very detailed assessment of the vitreoretinal transition prepapillary and premacullary, however with limited penetration depth and analyzation of deeper lying structures. Our observations suggest that prepapillary liquefaction and pressure gradients within cerebrospinal and intraokular pressure could be key factors.

摘要

目的

视盘小凹是一种先天性异常,其畸形类似于视盘缺损。视盘小凹黄斑病变的病因存在争议。我们使用高分辨率光学相干断层扫描(OCT)来研究视盘小凹眼内玻璃体视网膜和玻璃体视乳头交界处的变化。

方法

使用谱域光学相干断层扫描(SD-OCT)准确分析12只眼的玻璃体视网膜和玻璃体视乳头交界处。我们记录了以下标准:视乳头前玻璃体液化、视乳头玻璃体牵拉、玻璃体皮质连续性中断以及小凹与视网膜水肿之间的连通间隙。

结果

8只眼中发现小凹与视网膜水肿之间存在连通间隙。4只眼有视乳头玻璃体牵拉。4只眼显示玻璃体皮质连续性中断。12例患者中有2例在SD-OCT中未显示黄斑病变。这些患者有相邻的视乳头玻璃体,无视乳头前液化。然而,所有眼睛在黄斑前或视乳头前的某个阶段均显示玻璃体液化。

结论

尽管视盘小凹黄斑病变的病因尚不清楚。高分辨率OCT成像对视乳头前和黄斑前的玻璃体视网膜交界处提供了非常详细的评估,然而其穿透深度有限,对更深层结构的分析能力也有限。我们的观察结果表明,视乳头前液化以及脑脊液压力和眼内压的压力梯度可能是关键因素。

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