妊娠高血压综合征患者多光谱扫描激光成像与光学相干断层成像的图像特征

Q4 Medicine

中华眼底病杂志 Pub Date : 2020-01-25 DOI:10.3760/CMA.J.ISSN.1005-1015.2020.01.007

Lina Wang, Zengye Liu, Luning He, Zhihui Zhang, Cheng Ma, Chenming Gao

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引用次数: 1

摘要

目的观察妊娠高血压综合征(PIHS)患者多光谱扫描激光成像(MSLI)和OCT的图像特征。方法选取2016年5月至2017年5月在天津市第一中心医院产科就诊的PIHS患者112例(224眼)。患者平均年龄27.00±2.14岁。病程平均15.00±8.27 d。87例患者中有174只眼出现视力模糊、眼花、视疲劳等自觉症状。所有患者均行BCVA、直接检眼镜、B超、共聚焦扫描激光检眼镜(cSLO)和光谱域OCT (SD-OCT)检查。SD-OCT采用德国海德堡公司的Spectralis HRA+OCT进行断层成像。利用基于cSLO的Herdelberg彩色程序(MultiColor)，按照标准方法操作，一次扫描同时获得488 nm的蓝光反射、515 nm的绿光反射和820 nm的红外反射，合成MSLI。眼底异常分为动脉痉挛(Ⅰ期)、动脉硬化(Ⅱ期)、视网膜病变(Ⅲ期)，根据视网膜形态及厚度的异常情况进行OCT检查，分为正常与异常。结果224眼眼底检查正常68眼(30.36%)，异常156眼(69.64%)。其中分期Ⅰ28眼(17.95%);40眼为分期Ⅱ(25.64%);88眼为分期Ⅲ(56.41%)。眼底正常36眼(16.07%)，oct表现异常188眼(83.93%);眼底表现异常86眼(45.74%)视网膜神经上皮浆液性脱离;56眼(29.79%)有RPE脱离;视盘水肿、肿胀、视网膜神经纤维层局部反射增强和/或厚度增加46眼(24.47%)。MSLI患者48眼(21.43%)眼底正常;176只眼(78.57%)表现异常。MSLI上以绿色显示视网膜水肿，浆液性视网膜神经上皮层脱离，RPE层脱离，视网膜神经纤维层增厚，伴有局部视网膜结构改变。凸起程度越高，颜色越深。与SD-OCT显示的视网膜水肿范围一致。结论MSLI和SD-OCT图像显示PIHS患者病变高度一致。MSLI能更清晰地显示视网膜浅层和深部病变。关键词:高血压;妊高征;高血压性视网膜病变/诊断;层析成像，光学相干

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The image characteristics of multispectral scanning laser imaging and optical coherence tomography in patients with pregnancy induced hypertension syndrome

Objective To observe the image characteristics of multispectral scanning laser imaging (MSLI) and OCT in patients with pregnancy induced hypertension syndrome (PIHS). Methods A total of 112 patients (224 eyes) of PIHS patients diagnosed in Obstetrics Department of Tianjin First Central Hospital from May 2016 to May 2017 were included in this study. The average age of the patients was 27.00±2.14 years. The average course of the disease was 15.00±8.27 days. There were 174 eyes in 87 patients of blurred vision, dazzling and visual fatigue consciously. All patients performed BCVA, direct ophthalmoscope, B ultrasound, confocal scanning laser Ophthalmoscope (cSLO) and spectral-domain OCT (SD-OCT). SD-OCT was performed with Spectralis HRA+OCT from Heidelberg Company in Germany to acquire tomographic images. Using Herdelberg's colorful program (MultiColor) based on cSLO and operating in accordance with standard methods, one scan simultaneously obtained blue light reflection based on 488 nm, green light reflection based on 515 nm, and infrared reflection based on 820 nm, synthesis to MSLI. Fundus abnormalities were classified into arterial spasm (stage Ⅰ), arteriosclerosis (stage Ⅱ), and retinopathy (stage Ⅲ). OCT examination was divided into normal and abnormal cases according to the abnormality of retinal morphology and thickness. Results Of the 224 eyes, 68 eyes (30.36%) showed normal fundus examination and 156 eyes (69.64%) showed abnormal fundus performance. Among them, 28 eyes were stage Ⅰ (17.95%); 40 eyes were stage Ⅱ (25.64%); 88 eyes were stageⅢ (56.41%). Thirty-six eyes (16.07%) showed normal fundus and 188 eyes (83.93%) showed abnormal performance with OCT. Of the 188 eyes with abnormal fundus performance, 86 eyes (45.74%) had retinal neuroepithelial serous detachment; 56 eyes (29.79%) had RPE detachment; optic disc edema, bulge, and local reflexes in the retinal nerve fiber layer were enhanced and/or the thickness increased in 46 eyes (24.47%). In MSLI, 48 eyes (21.43%) showed normal fundus; 176 eyes (78.57%) showed abnormal performance. Retinal edema was showed in green on MSLI, serous retinal neuroepithelial layer detachment, RPE layer detachment, retinal nerve fiber layer thickening, accompanied by changes in local retinal structure. The higher the degree of bulge, the darker the color. Consistent with the range of retinal edema revealed by SD-OCT. Conclusions MSLI and SD-OCT images show highly consistent lesions in PIHS patients. MSLI can more clearly show superficial and deep retinal lesions. Key words: Hypertension, pregnancy-induced; Hypertensive retinopathy/diagnosis; Tomography, optical coherence

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来源期刊

中华眼底病杂志 Medicine-Ophthalmology

CiteScore

0.40

自引率

0.00%

发文量

5383

期刊介绍： Chinese Journal of Ocular Fundus Diseases is the only scientific journal in my country that focuses on reporting fundus diseases. Its purpose is to combine clinical and basic research, and to give equal importance to improvement and popularization. It comprehensively reflects the leading clinical and basic research results of fundus disease disciplines in my country; cultivates professional talents in fundus disease, promotes the development of fundus disease disciplines in my country; and promotes academic exchanges on fundus disease at home and abroad. The coverage includes clinical and basic research results of posterior segment diseases such as retina, uveal tract, vitreous body, visual pathway, and internal eye diseases related to systemic diseases. The readers are medical workers and researchers related to clinical and basic research of fundus diseases. According to the journal retrieval report of the Chinese Institute of Scientific and Technological Information, the comprehensive ranking impact factor and total citation frequency of the Chinese Journal of Ocular Fundus Diseases have been among the best in the disciplines of ophthalmology, otolaryngology, and ophthalmology in my country for many years. The papers published have been included in many important databases at home and abroad, such as Scopus, Peking University Core, and China Science Citation Database (CSCD).