Objective To identify the characteristics of and evaluate surgical impact on idiopathic macular hole (IMH) by using an optical coherence tomography (OCT) scanner. Methods Sixty-five cases (70 eyes) experiencing IMH were examined using OCT, then graded by their clinical characteristics. Nineteen cases (19 eyes) were scanned and measured using OCT before and after surgery. Results Of the 70 eyes, the number of stage I-IV macular holes were 11, 12, 36 and 11, respectively. For stage I holes, the OCT images revealed flattened or nonexistent fovea and minimally reflective space within or beneath the neurosensory retina; stage Ⅱ holes appeared to be full-sized with attached operculum and surrounding edema; stage Ⅲ holes were also full-sized with surrounding edema; finally, stage IV holes were full-sized and completely separated the posterior hyaloid membrane from the retina. Through quantitative measurements, OCT determined that the values for mean hole diameter, mean halo diameter and mean thickness of the hole's edge were reduced from 570.95±265.59 to 337.05±335.95μm, 1043.53±278.8 to 695.00±483.00μm and 389.78±60.58 to 298.78±109.80μm, respectively in 19 IMH cases after surgery. In 17 eyes, the holes or halos eventually closed or were reduced in size, or the edges of the holes thinned out. The anatomic successful rate of the surgery was 89%. Conclusion OCT can exhibit the characteristics of IMH and measure the diameter of holes quantitatively. This method can also judge the surgical impacts of IMH objectively, accurately and effectively.

Objectives To investigate image characteristics and thickness of the retinal nerve fiber la yer (RNFL) in normal and glaucomatous eyes using optical coherence tomography (OCT), and analyze the relationship between RNFL thickness and visual field index. Methods Eighty-three normal persons (150 eyes) and 83 patients with primary open angle glaucoma (POAG, 149 eyes) underwent OCT examinations with 3.4mm diameter circ le scan to calculate the RNFL thickness. Statistical analysis was used to compa re differences in RNFL thickness in quadrants and means between the normal and glaucomatous groups and the different stages of POAG. Linear correlation and reg ression analysis were used to show the correlation between RNFL thickness and vi sual field index of 115 eyes in glaucomatous patients. Reproducibility, sensiti vity and specificity of RNFL measurements using OCT were evaluated. Results RNFL thickness measured by OCT in normal subjects was thicker in superior and in ferior, less in temporal, and thinnest in nasal quadrants. The curve showed dou ble peaks. RNFL of glaucomatous patients showed local thinning or defect, diffu se thinning, or both. The mean RNFL thicknesses of the normal group in the temp oral, superior, nasal and infeior quadrants were 90.1±10.8μm, 140.4±10.5μm, 85.2±14.0μm, and 140.4±9.7μm, respectively with a mean of 114.2±6.0μm.The numbers for the glaucomatous group were respectively 56.0±31.0μm, 81.0±36.3μm, 47.1±27.5μm, and 73.4±38.4μm for th e four quadrants, with a mean of 64.6±28.8μm. There was a significant dif ference in RNFL thickness between the normal and glaucomatous groups (P<0.000), and the three stages (early, developing and late) of glaucomatous groups (P<0.000). There was a close negative relationship between RNFL thickness a nd visual field index (r=-0.796, P<0.0001). The sensitivity and speci ficity of RNFL thickness in POAG measured using OCT were 93.3% and 92.0%, res pectively. Conclusions OCT can quantitatively measure RNFL thickness differences between normal persons and glaucomatous patients. RNFL thickness gradually decreases while visual fie ld defect increases with the development of POAG.

目的 获取正常人视乳头地形图总体与局部参数正常值及其形态特征，探讨性别、眼别、年龄和视盘面积（DA）地形图参数的关系。方法 运用海德堡视网膜断层扫描仪（Heidelberg retinatolnograph，HRT）检测116例（216只正常眼）正常人视乳头地形图总体和局部参数，分析性别、眼别、年龄与视乳头地形图参数的关系，将DA以1.5mm2和2.5mm2为界分为小、中、大视盘三组进行各组参数的比较。结果 正常人116例（116只眼）视乳头地形图正常值：DA为（2.028±0.411）mm2，视杯面积（CA）为（0.466±0.355）mm2，杯/盘面积（C/DAR）比值为（0.217±0.137），盘沿面积（RA）为（1.563±0.339）mm2，视乳头轮廓线高度变化（HVC）值为（0.404±0.096）mm，视杯容积（CV）为0.127mm3，盘沿容积（RV）为（0.446±0.173）mm3，平均视杯深度（MCD）为（0.196±0.096）mm，最大视杯深度（MxCD）为（0.559±0.228）mm，视杯形态测量（CSM）为（-0.213±0.076）mm，平均视网膜神经纤维层厚度（mRNFLT）为（0.272±0.076）mm，视网膜神经纤维层截面面积（RNFLA）为（1.364±0.375）mm2。性别司各参数差异无显著意义（P>0.05）。C/DAR、RA及RV值眼别司差异有显著意义（P<0.05），正常人的C/DAR比值双眼差值范围为0.00～0.18。mRNFLT和RNFLA值与年龄呈负相关关系。视乳头地形图局部参数显示：CA、C/DAR及CV值以鼻侧为最小，颞侧最大；RA和RV值以颞侧最小；MCD和MxCD为颞侧最深；mRNFLT和RNFLA值为颞侧最小，上方最大。DA值在小、中、大视盘三组司大部分参数差异有显著意义（P<0.05），但mRNFLT、RNFLA及RV值三组司差异无显著意义（P>0.05）。结论 正常人视乳头地形图参数正常值变异较大；年龄、视盘面积大小对视乳头地形图参数有一定影响；眼别司部分参数差异有显著意义，而性别司视乳头地形图各参数司差异无显著意义；视乳头地形图各象限参数有所不同。

目的 观察视网膜中央动脉阻塞（CRAO）的光相干断层扫描（OCT）病理形态学改变特征。方法 通过检眼镜，荧光素眼底血管造影（FFA）检查确诊的CRAO患者53例（53只眼）进行OCT检查，所有患者发病2周内。OCT检查采用水平或垂直线性扫描，扫描部位为黄斑区、后极部视网膜、视盘及出血、渗出等相应病灶部位。结果 CRAO的OCT活体病理改变的图像特征包括黄斑区及后极部全层视网膜厚度增加、反射增强，光感受器暗区增宽（水肿）；黄斑中心凹水肿或囊样水肿；后极部视网膜出血及棉絮斑可有不同的OCT表现；视盘边缘隆起，呈水肿改变；其中4例患者伴有睫状视网膜动脉，在睫状视网视膜动脉供应区视网膜结构正常。 结论 OCT可以无创伤地在活体上观察CRAO的视网膜组织病理改变，特别适用于不允许进行FFA检查的高龄或合并全身病的CRAO患者，其独特的OCT图像病理改变可以为临床即时诊断提供客观依据。

【目的】探讨羊膜在青光眼滤过手术中应用的降压效果及安全性。【方法】将各类型青光眼38例44只眼分为3组，A组为巩膜瓣下羊膜移植术（AMT）组（20只眼）；B组为巩膜瓣下联合应用丝裂霉素组（12只眼）；C组为对照组（12只眼），行单纯小梁切除术。观察手术前、术后第1、2、3、7、14、21天、第1、3、6个月各组的视力、眼压、滤过泡类型和充血程度、前房深度、眼底情况及并发症，用前房激光蛋白细胞检测仪（LFCM）测量术前和术后第1、3、7天和1个月的前房蛋白含量，进行统计学分析。【结果】3组术后平均眼压均控制在21mmHg以下，术后7～14d眼压最低：3组各观察点之间比较P值均大于0.05，差异无显著性。44只眼中40只眼为Ⅱ型滤过泡，4只眼为包裹性囊状滤过泡。羊膜组滤过泡术后2d较扁平，第3天起隆起呈弥散的Ⅱ型泡；羊膜组早期滤过泡充血较轻，与其它两组比较差异有显著性（P<0.05）。羊膜组前房蛋白含量术前、术后第1天、第30天均高于其他两组，差异有显著性（P<0.05）。【结论】羊膜运用于青光眼滤过手术中可以有效地降低眼压，减轻炎症反应，并发症较少。羊膜移植术后前房房水蛋白含量增加，可能与羊膜本身蛋白溶解有关。