初发单眼眼前黑影飘动患者的光相干断层扫描特征

doi:10.6040/j.issn.1673-3770.0.2024.039

摘要/Abstract

摘要： 目的探讨初发单眼黑影飘动患者光相干断层扫描(optical coherence tomography, OCT)的影像特征。方法本研究为前瞻性病例系列研究。将主诉为1周内单眼黑影飘动113例(113眼)纳入本研究。所有患眼在基线和6周后行视力、眼压、裂隙灯显微镜、散瞳间接眼底镜、超广角扫描激光眼底成像(scanning laser fundoscopy, SLO)、OCT检查。SLO和OCT的图像采集在散瞳前进行。结果视网膜裂孔在玻璃体腔点状高反射阳性组和阴性组占比分别为29.2%和2.2%(χ2=21.856, P<0.001)。周边部视网膜前条带状出血在玻璃体腔点状高反射阳性组和阴性组占比分别为29.2%和1.1%(χ2=26.139, P<0.001)。OCT的红外谱图(infrared spectroscopy,IR)中,视网膜裂孔在多个视网膜前遮挡影阳性组和阴性组占比为38.5%和4%(χ2=18.639, P<0.001)。周边部视网膜前条带状出血在多个视网膜前遮挡影阳性组占比高于阴性组,差异均有统计学意义(χ2=48.839, P<0.001)。结论初发单眼黑影飘动患者的OCT上观察到玻璃体腔点状高反射,IR图中出现多个视网膜前遮挡影,需考虑视网膜裂孔或视网膜前出血。

关键词: 玻璃体腔点状高反射, 光相干断层扫描, 视网膜裂孔, 黑影飘动, 视网膜脱离

Abstract: Objective To observe the imaging features of optical coherence tomography(OCT)in patients with incipient monocular black shadow flutter. Methods This study was a prospective case series. 113 cases(113 eyes)with complaints of monocular dark shadow flutter within 1 week were included in this study. All affected eyes underwent visual acuity, intraocular pressure, slit lamp microscopy, indirect fundoscopy with dilated pupil, super wide angle scanning laser fundoscopy(SLO), and OCT at baseline and 6 weeks later. image acquisition for SLO and OCT was performed before dilating the pupil. Results The proportion of retinal tears in the vitreous cavity with punctate hyperreflectivity was 29.2% and 2.2% in the positive and negative groups, respectively(χ2=21.856, P<0.001). The preretinalstriated hemorrhages of the peripheral cavity were 29.2% and 1.1%(χ2=26.139, P<0.001)in the vitreous cavity punctate hyperreflective positive and negative groups, respectively. In infrared spectroscopy(IR)of OCT, retinal fissures were 38.5% and 4%(χ2=18.856, P<0.001)in the positive and negative groups of multiple pre-retinal occluding shadows. 4%(χ2=18.639, P<0.001). Peripheral pre-retinal strip hemorrhages were more prevalent in the multiple pre-retinal masking shadow positive group than in the negative group, and the difference was statistically significant in all cases(χ2=48.839, P<0.001). Conclusion The observation of punctate hyperreflectivity of the vitreous cavity in OCT and the presence of multiple pre-retinal masking shadows on IR maps in patients with initial monocular black shadow flutter need to be considered for retinal tears or pre-retinal hemorrhages.

Key words: Vitreous cavity hyper reflection, Optical coherence tomography, Retinal tears, Floaters, Retina detachment

中图分类号:

R776.4

张露,王永晶,贾君,赵健楠,赵芳. 初发单眼眼前黑影飘动患者的光相干断层扫描特征[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 85-88.

ZHANG Lu, WANG Yongjing, JIA Jun, ZHAO Jiannan, ZHAO Fang. Spectral domain optical coherence tomography imaging characteristics in patients with initial onset floaters[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 85-88.

参考文献

[1] Davis MD. Natural history of retinal breaks without detachment[J]. Arch Ophthalmol, 1974, 92: 183-194. doi: 10.1001/archopht.1974.01010010191001
[2] Hollands H, Johnson D, Brox AC, et al. Acute-onset floaters and flashes: is this patient at risk for retinal detachment?[J]. JAMA, 2009, 302(20): 2243-2249. doi:10.1001/jama.2009.1714
[3] Tanner V, Harle D, Tan J, et al. Acute posterior vitreous detachment: the predictive value of vitreous pigment and symptomatology[J]. Br J Ophthalmol, 2000, 84(11): 1264-1268. doi:10.1136/bjo.84.11.1264
[4] Li M, Yang D, Shen Y, et al. Application of mydriasis and eye steering in ultrawide field imaging for detecting peripheral retinal lesions in myopic patients[J]. Br J Ophthalmol, 2023, 107(7): 1018-1024. doi:10.1136/bjophthalmol-2021-319809
[5] Rayess N, Rahimy E, Vander JF, et al. Spectral-domain optical coherence tomography in acute posterior vitreous detachment[J]. Ophthalmology, 2015, 122(9): 1946-1947. doi:10.1016/j.ophtha.2015.03.030
[6] 刘江川,李鹏伟,郭建强, 等. 光学相干断层扫描成像在特发性视网膜前膜中的应用研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(1):138-142. doi:10.6040/i.issn.1673-3770.0.2022.531 LIU Jiangchuan, LI Pengwei, GUO Jianqiang, et al. Application of optical coherence tomography in idiopathic epiretinal membrane[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(1):138-142. doi:10.6040/i.issn.1673-3770.0.2022.531
[7] 尤冉, 郭笑霄, 王薇, 等. 高度近视患者黄斑区视网膜劈裂分型与脉络膜特征分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 83-87. doi:10.6040/j.issn.1673-3770.0.2022.528 YOU Ran, GUO Xiaoxiao, WANG Wei, et al. Association of macular retinoschisis severity with choroidal parameters in patients with high myopia[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(3): 83-87. doi:10.6040/j.issn.1673-3770.0.2022.528
[8] Flaxel CJ, Adelman RA, Bailey ST, et al. Posterior vitreous detachment, retinal breaks, and lattice degeneration preferred practice pattern?[J]. Ophthalmology, 2020, 127(1): 146-181. doi:10.1016/j.ophtha.2019.09.027
[9] Tsukahara M, Mori K, Gehlbach PL, et al. Posterior vitreous detachment as observed by wide-angle OCT imaging[J]. Ophthalmology, 2018, 125(9): 1372-1383. doi:10.1016/j.ophtha.2018.02.039
[10] Pole C, Au A, Navajas E, et al. En face optical coherence tomography imaging of foveal dots in eyes with posterior vitreous detachment or internal limiting membrane peeling[J]. Invest Ophthalmol Vis Sci, 2021, 62(10): 5. doi:10.1167/iovs.62.10.5
[11] Itakura H, Itakura M, Sato T. Stardust sign and retinal tear detection on swept source optical coherence tomography[J]. Retina, 2022, 42(2): 336-339. doi:10.1097/IAE.0000000000003317

相关文章 15

[1]	卢松,夏逸帆,李子晔,魏菁. 无视网膜脱离的儿童Stickler综合征1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 97-101.
[2]	孟博,王康,罗丽华,王艳玲,李爽. 基于WOS数据库的高度近视黄斑裂孔性视网膜脱离研究特征及趋势分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 84-90.
[3]	杨雪鹏,史陇,崔彦. 先天性白内障术后视网膜脱离合并睫状体环形纤维增生1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 51-55.
[4]	鹿文瑞,严端,许诺. 25G玻璃体切除治疗上方孔源性视网膜脱离的疗效[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 89-91.
[5]	周怀胜,梁婉玲,郎海波,冼志林,晏世刚,孔祥斌,沈沛阳. 超广角眼底照相在孔源性视网膜脱离患者术前检查的临床应用[J]. 山东大学耳鼻喉眼学报, 2021, 35(3): 96-99.
[6]	周学义,李一鸣,王美菊,张苑苑,张历浊. 25+微创玻璃体视网膜手术治疗孔源性视网膜脱离的临床观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 92-94.
[7]	乔岗,代艳,郭海科,郭道林,卫云峰,李娟. 超声造影在诊断困难的视网膜脱离、脉络膜脱离及眼内肿块中的应用[J]. 山东大学耳鼻喉眼学报, 2016, 30(2): 91-93.
[8]	张京京1,韩方菊2 . 玻璃体手术治疗伴脉络膜脱离的孔源性视网膜脱离临床研究[J]. 山东大学耳鼻喉眼学报, 2014, 28(1): 70-72.
[9]	林琳1，王玉2，吴昌龙2，盛艳娟2. 激光治疗周边浅层孔源性视网膜脱离的临床观察[J]. 山东大学耳鼻喉眼学报, 2012, 26(3): 70-71.
[10]	李传宝1，张传坤2，丁建光1，梁勇3，何淑艳1，胡兆磊1. 节段性巩膜外加压手术治疗孔源性视网膜脱离[J]. 山东大学耳鼻喉眼学报, 2010, 24(5): 58-61.
[11]	孙先勇黄旭东黄静徐鑫彦娄华东. 孔源性视网膜脱离的最小量视网膜手术[J]. 山东大学耳鼻喉眼学报, 2009, 23(3): 72-74.
[12]	正刘伟1，2 ，傅特1 ，杨君1 ，王玉1 . 视网膜脱离术后限制性斜视的特征和手术矫[J]. 山东大学耳鼻喉眼学报, 2009, 23(2): 91-93 .
[13]	朱海容 . 孔源性视网膜脱离节段性垫压术后再手术原因及术式选择[J]. 山东大学耳鼻喉眼学报, 2009, 23(1): 90-91 .
[14]	董卫红,周芳,毕宏生,王兴荣,杜秀娟,马先祯,俞超 . 急性视网膜坏死综合征临床治疗42眼[J]. 山东大学耳鼻喉眼学报, 2008, 22(5): 457-459 .
[15]	刘丽萍 . 眼内硅油填充术后早期高眼压原因及处理[J]. 山东大学耳鼻喉眼学报, 2007, 21(6): 568-569 .

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed