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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:

36卷

期数:

2016年4期

页码:

345-348

栏目:

应用研究

出版日期:

2016-04-05

文章信息/Info

Title:

Diagnostic values of OCT for central retinal artery occlusion

作者:

李伟; 张奕霞

832000　新疆维吾尔自治区石河子市，石河子大学医学院

Author(s):

LI Wei; ZHANG Yi-Xia

School of Medicine Shihezi University, Shihezi 832000 , Xinjiang Uygur Autonomous Region , China

关键词:

光学相干断层扫描; 视网膜中央动脉阻塞; 黄斑区中心小凹厚度; 诊断价值

Keywords:

optical coherence tomography ;  central retinal artery occlusion ; macular central fovea thickness ;  diagnostic value

DOI:

10.13389/j.cnki.rao.2016.0093

文献标志码:

A

摘要:

目的　研究光学相干断层扫描（ｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ，ＯＣＴ）在视网膜中央动脉阻塞（ｃｅｎｔｒａｌｒｅｔｉｎａｌａｒｔｅｒｙｏｃｃｌｕ-ｓｉｏｎ，ＣＲＡＯ）上的诊断价值。方法　应用眼底荧光血管造影（ｆｕｎｄｕｓｆｌｕｏｒｅｓｃｅｉｎａｎｇｉｏｇｒａｐｈｙ，ＦＦＡ）将黄斑水肿患者分成病例组（ＣＲＡＯ患者）、对照组［即视网膜中央静脉阻塞（ｃｅｎｔｒａｌｒｅｔｉｎａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＣＲＶＯ）患者及糖尿病性黄斑水肿（ｄｉａｂｅｔｉｃｍａｃｕｌａｒｅ-ｄｅｍａ，ＤＭＥ）患者］。测量黄斑中心小凹从内界膜到色素上皮层之间的厚度（黄斑中心小凹厚度）；通过黄斑中心小凹中点向色素上皮层作垂线，连接黄斑中心小凹中点与鼻侧距中心小凹２００μｍ处作一直线，测量垂线与上述直线所形成的夹角（简称角度）。对数据进行统计学分析。结果　黄斑区水肿在ＯＣＴ扫描中的主要表现为：黄斑区囊样水肿，视网膜神经上皮下积液，视网膜内层细胞内水肿。病例组和对照组的黄斑中心小凹厚度及角度差异均有统计学意义（均为Ｐ＜０．０５）；将测得的黄斑中心小凹厚度绘制ＲＯＣ曲线，曲线下面积为０．９１２，最佳临界值为２０５．００μｍ，该点灵敏度０．９０，特异度０．８７，Ｙｏｕｄｅｎ指数０．７７；将测得的角度绘制ＲＯＣ曲线，曲线下面积为０．９６６，最佳临界值为７２．００°，该点灵敏度０．９７，特异度０．９０，Ｙｏｕｄｅｎ指数０．８７。结论　两种诊断方法都说明ＯＣＴ对ＣＲＡＯ有较好的诊断价值，但测量角度灵敏度和特异度都较测量黄斑中心小凹高，说明有更高的准确率。

Abstract:

Objective To study the diagnostic value of optical coherence tomography ( OCT) for central retinal artery occlusion ( CRAO) . Methods By fundus fluorescein angiography ( FFA) , the macular edema patients were divided into the case group ( CRAO patients) .control group [ central retinal vein occlusion ( CRVO) patients and diabetic macular edema ( DME) patients ] . OCT was used to measure the thickness of macular central pits between the inner limiting membrane and pigment epithelium layer,in the following referred to the central macular foveola thickness. Through the center point of central macular foveola,the perpendicular was done to the pigment epithelium layer, connecting the center point of central macular foveola and nasal macular pits ranging 200 Vm made a straight line.and the angle formed by the vertical and the straight line was measured, in the following referred to as the angle. Results The main frndings of macular edema of this study in OCT scan included the cystoids macular edema . subcutaneous effusion of retina and retinal inner cell edema. There were significant differences in macular foveola thickness and angle between the case group and control group( all P < 0. 05 ) ; Drawing ROC curve through the measured macular thickness , the area under the ROC curve was 0. 912 , the optimal critical value of macular central thickness of fovea to diagnose the CRAO was 205. 00 ym , the point sensitivity was 0. 90 , the specificity was 0. 87 , and the Youden index was 0. 77 ; Drawing ROC curve through the angle , the area under the ROC curve was 0. 966,the optimal critical value of angle to diagnose the CRAO was 72. 000 , the point sensitivity was 0. 97 , the Specificity was 0. 90 , and the Youden index was 0. 87. Conclusion Two kinds of diagnosis methods all show that OCT has good diagnostic value for CRAO , but the sensitivity and specificity for the measurement of angle are higher than those for the measurement of macular fovea thickness ,which is more accurate.

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更新日期/Last Update: 2016-04-01