频域光学相干层析成像对视网膜大动脉瘤的观察研究
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摘要
目的利用频域光学相干层析成像(OCT)观察视网膜大动脉瘤(RAM)的形态特征。方法回顾研究2014年7月~2017年12月于我院确诊的RAM患者的临床资料,分析OCT图像中RAM瘤体及其周围视网膜,以及黄斑的形态。结果 16例(16眼)患者入选。OCT显示,16眼RAM瘤体均表现为视网膜浅层轻度隆起的半圆形高反射病灶,其深部组织反射遮蔽。RAM瘤体周围视网膜病变包括:水肿16眼(100%),神经上皮下积液5眼(31.3%),渗出7眼(43.8%)。15眼(93.8%)还存在黄斑病变:黄斑水肿6眼(37.5%),黄斑神经上皮下积液6眼(37.5%),黄斑渗出10眼(62.5%),6眼存在2种或以上黄斑病变。结论 RAM瘤体在频域OCT中显示特征表现,有利于RAM的早期诊断,也为进一步治疗提供依据。
Objective To investigate the morphological characteristics of retinal arterial macroaneurysm( RAM) in spectral domain optical coherence tomography( OCT). Methods Medical records of the patients diagnosed as RAM from Jul. 2014 to Dec. 2017 were retrospectively reviewed. Clinical data were collected,and the OCT images were further analyzed. Results In total,16 eyes from 16 patients were included. All the macroaneurysms had a typical OCT appearance,a round hyperreflective wall with a hyporeflective lumen. RAM associated OCT findings included retinal edema( 16 eyes,100%),subretinal fluid( 5 eyes,31. 3%) and intraretinal lipids( 7 eyes,43. 8%).Fifteen( 93. 8%) eyes also had macular abnormalities,including retinal edema( 6 eyes,37. 5%),subretinal fluid( 6 eyes,37. 5%) and intraretinal lipids( 10 eyes,62. 5%). Conclusions Based on the typical appearance in OCT,RAM can be diagnosed early. It could be helpful in planning the treatment of RAM.
Objective To investigate the morphological characteristics of retinal arterial macroaneurysm( RAM) in spectral domain optical coherence tomography( OCT). Methods Medical records of the patients diagnosed as RAM from Jul. 2014 to Dec. 2017 were retrospectively reviewed. Clinical data were collected,and the OCT images were further analyzed. Results In total,16 eyes from 16 patients were included. All the macroaneurysms had a typical OCT appearance,a round hyperreflective wall with a hyporeflective lumen. RAM associated OCT findings included retinal edema( 16 eyes,100%),subretinal fluid( 5 eyes,31. 3%) and intraretinal lipids( 7 eyes,43. 8%).Fifteen( 93. 8%) eyes also had macular abnormalities,including retinal edema( 6 eyes,37. 5%),subretinal fluid( 6 eyes,37. 5%) and intraretinal lipids( 10 eyes,62. 5%). Conclusions Based on the typical appearance in OCT,RAM can be diagnosed early. It could be helpful in planning the treatment of RAM.
引文
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[2]Lavin MJ,Marsh RJ,Peart S,et al.Retinal arterial macroaneurysms:a retrospective study of 40 patients[J].Br J Ophthalmol,1987,71(11):817-825.
[3]Moosavi RA,Fong KC,Chopdar A.Retinal artery macroaneurysms:clinical and fluorescein angiographic features in 34 patients[J].Eye(Lond),2006,20(9):1011-1020.
[4]Rabb MF,Gagliano DA,Teske MP.Retinal arterial macroaneurysm[J].Surv Ophthalmol,1988,33(2):73-96.
[5]Fichte C,Streeten BW,Friedman AH.A histopathologic study of retinal arterial macroaneurysms[J].Am J Ophthalmol,1978,85(4):509-518.
[6]李娟娟,黎铧,韦春玲,等.视网膜大动脉瘤16例临床观察[J].中华眼底病杂志,2013,29(3):312-314.
[7]王涛,张惠蓉,鹿新荣,等.视网膜大动脉瘤的临床特点[J].中华眼科杂志,2008,44(6):521-524.
[8]Parodi MB,Iacono P,Ravalico G,et al.Subthreshold laser treatment for retinal arterial macroaneurysm[J].Br J Ophthalmol,2011,95(4):534-538.
[9]Lee EK,Woo SJ,Ahn J,et al.Morphologic characteristics of retinal arterial macroaneurysm and its regression pattern on spectral-domain optical coherence tomography[J].Retina,2011,31(10):2095-2101.
[10]Pichi F,Morara M,Torrazza C,et al.Intravitreal bevacizumab for macular complications from retinal arterial macroaneurysms[J].Am J Ophthalmol,2013,155(2):287-294.e1.
[11]Lewis RA,Norton EW,Gass JD.Acquired arterial macroaneurysms of the retina[J].Br J Ophthalmol,1976,60(1):21-30.
[12]Cho HJ,Rhee TK,Kim HS,et al.Intravitreal bevacizumab for symptomatic retinal arterial macroaneurysm[J].Am J Ophthalmol,2013,155(5):898-904.
[13]Yu J,Jiang C,Shi G,et al.Variable photoreceptor inner and outer segment junction appearance in central serous chorioretinopathy[J].Retina,2014,34(7):1492-1493.
[14]Panton RW,Goldberg MF,Farber MD.Retinal arterial macroaneurysms:risk factors and natural history[J].Br J Ophthalmol,1990,74(10):595-600.
[15]Sato T,Kishi S,Watanabe G,et al.Tomographic features of branching vascular networks in polypoidal choroidal vasculopathy[J].Retina,2007,27(5):589-594.
[16]Cho M,Athanikar A,Paccione J,et al.Optical coherence tomography features of acute central serous chorioretinopathy versus neovascular age-related macular degeneration[J].Br J Ophthalmol,2010,94(5):597-599.