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光学相干断层扫描在急性后玻璃体脱离及其并发症治疗中的作用。

ROLE OF OPTICAL COHERENCE TOMOGRAPHY IN MANAGEMENT OF ACUTE POSTERIOR VITREOUS DETACHMENT AND ITS COMPLICATIONS.

机构信息

Department of Ophthalmology, Pennsylvania State College of Medicine, Hershey, Pennsylvania.

Lehigh Eye Specialists, P.C., Allentown, Pennsylvania.

出版信息

Retina. 2023 Mar 1;43(3):371-378. doi: 10.1097/IAE.0000000000003741.

Abstract

PURPOSE

Currently, no consensus exists on the role of optical coherence tomography (OCT) imaging in the setting of acute posterior vitreous detachment (PVD). The authors outline the clinical utility of OCT in the management of acute PVD and its complications.

METHODS

Literature review of OCT findings in association with acute PVD and report of illustrative cases.

RESULTS

Optical coherence tomography imaging in the setting of acute PVD can provide details of vitreoretinal interface that are difficult to appreciate on biomicroscopy alone including partial PVDs, focal vitreoretinal adhesions and traction, and subclinical macular changes. The presence of vitreous hyperreflective dots on OCT in the premacular space, especially if severe, is highly correlated with the presence of peripheral retinal breaks and development of epiretinal membrane. Advancements in OCT technology, including enhanced vitreous imaging OCT, swept-source OCT, wide-angle OCT, and widefield OCT, allow for increased resolution and expanded field of imaging of the vitreoretinal interface.

CONCLUSION

Optical coherence tomography imaging is an emerging standard of care in the setting of patients presenting with new flashes and floaters. The authors highlight the benefits of OCT imaging in patients with acute PVD, which includes recognition of the status of the vitreoretinal interface, assistance in identifying high-risk PVDs, and performance of risk assessment that predict future macular pathologic condition.

摘要

目的

目前,对于急性后玻璃体脱离(PVD)情况下光学相干断层扫描(OCT)成像的作用尚无共识。作者概述了 OCT 在急性 PVD 及其并发症管理中的临床应用。

方法

对与急性 PVD 相关的 OCT 发现进行文献回顾,并报告说明性病例。

结果

在急性 PVD 情况下进行 OCT 成像可以提供单凭生物显微镜难以观察到的玻璃体视网膜界面的详细信息,包括部分 PVD、局灶性玻璃体视网膜粘连和牵引以及亚临床黄斑改变。黄斑前空间 OCT 上存在玻璃体高反射点,尤其是严重时,与周边视网膜裂孔的存在和视网膜内膜的发展高度相关。OCT 技术的进步,包括增强玻璃体成像 OCT、扫频源 OCT、广角 OCT 和宽场 OCT,允许提高分辨率并扩大玻璃体视网膜界面的成像视野。

结论

OCT 成像在出现新闪光和漂浮物的患者中是一种新兴的护理标准。作者强调了 OCT 成像在急性 PVD 患者中的益处,包括识别玻璃体视网膜界面的状态、协助识别高危 PVD 以及进行风险评估以预测未来的黄斑病理状况。

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