| OBJECTIVE To study the characteristics and clinical applicatior value of the optical coherence tomography (OCT) of macular hole ,epimacular membrane,maculai edema,and vitreofoveal traction sydrome. METHOD l.A total of the 35 patients with the clinical diagnosis of macular hole were examined with OCT betweer September and December 1998.OCT imaging was conductec through a dilated pupil, and the OCTimages were analyzec and measured. 2.To evaluate the surgical effect of idiopathic maculai hole, with optical coherence tomography,to measure thc diameter of holes and hole halos,the thickness of hole ir edge,the changes of hole pattern in 23 cases(23 eyes)witl idiopathic macular hole using OCT. 3.Optical coherence tomography of epimacular membrane:A total of 42 patients with the clinical diagnosis of epimacular membrane were examined with OCT. the OCT images were analyzed and measured. 4.Antomic evaluation of vitreous surgery of epimacular membrane with OCT: to analyse and measure the images of epimacular membrane in 12 cases before and after surgery. 5 .Macular edema: A tofal of 18 cases with macular edema wered examined with OCT before and after treatment. The OCT images were aualyzed and measured. 6.To eveluate the surgical effect of vitreomacular traction syndrome with OCT. RESULTS: 1. Of the 35 patients examined with OCT, there were pseudohole and epimacular membrane in one eye, vitreofoveal traction in one eye, macular holes in 36 eyes, and 3 patients had macular hole in bilateral eyes. In 4 eyes, there were partial-thickness of neural epithelium in the fovea without halo of retinal detachment was shown in the OCT image. In 32 eyes, there were full-thickness holes. The OCT displayed complete losing of the whole thickness of the neural epithelium in the fovea, sharp edge of the hole and the halo of retinal detachment around the hole. Sometimes nonreflective cavities could be seen within the retina,and the retinal thickness around the hole was increased.According to Gass stage classification of macular hole, there were 2 eyes with impending hole, 3 eyes in stage 2, 15 eyes in stage 3, and 6 eyes in stage 4.4 eyes underwent vitrectomy. The OCT imaging after the surgery demonstrated the closure of hole and the disappearance of halo surrounding the hole. Through 7 quantitative measurement, the diameter of the hole was (565.88 ?0.35) urn, the diameter of the halo was (1338.76 ?147.57)um, and the retinal thickness surrounding the hole was (391.87?18.97)um. The sizes of the hole and the halo and the retinal thickness around the hole were correlated with the vision. 2.By quantitatively measuring, OCT showed that after surgery the mean hole diameter lessened from(540.23 ? 34,35)llm to (312.10?4.70)llm. The mean diameter of hole halo lessened from (1243.15 ?264.28)itm to (746.35 ? 286.42) jim and the mean thickness of hole edge thinned from (352.26?6.24)jim to (268.86?16.35) jim. In 19 cases the holes became closed or reduced in size or the hole halo, and thinned in hole edge, the anatomic successful rate of the surgery is 83%.OCT can objectively, accurately and effectively judge the anatomic effect of idiopathic macular hole surgery. 3 .Base... |
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