国际眼科纵览 ›› 2023, Vol. 47 ›› Issue (5): 429-435.doi: 10.3760/ cma.j.issn.1673-5803.2023.05.008

• 综述 • 上一篇    下一篇

特发性黄斑前膜及其OCT和OCTA影像学特点

王鸽纯1,2 袁非1   

  1. 1 复旦大学附属中山医院眼科,上海 200032;2 武警浙江总队医院眼科,杭州 310052
  • 收稿日期:2023-09-27 出版日期:2023-10-22 发布日期:2023-11-06
  • 通讯作者: 袁非,Email: yuan.fei@zs-hospital.sh.cn E-mail:yuan.fei@zs-hospital.sh.cn
  • 基金资助:
    中山医院学科建设基金(XK-073-6)

Idiopathic macular epiretinal membrane and its OCT and OCTA imaging features

Wang Gechun1,2, Yuan Fei1   

  1. 1 Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai 200032, China; 2 Department of Ophthalmology, Hospital of Zhejiang People's Armed Police, Hangzhou 310052, China
  • Received:2023-09-27 Online:2023-10-22 Published:2023-11-06
  • Contact: Yuan Fei, Email: yuan.fei@zs-hospital.sh.cn E-mail:yuan.fei@zs-hospital.sh.cn
  • Supported by:
    Zhongshan Hospital Subject Construction Fund (XK-073-6)

摘要: 黄斑前膜指位于黄斑区视网膜内表面的非血管性纤维细胞膜,其中特发性黄斑前膜(idiopathic macular epiretinal membrane,iERM)约占其80%。目前,相干光断层扫描(optical coherence tomography,OCT)是诊断iERM的首选方法。OCT技术能够在早期阶段观察到黄斑区视网膜内层增强增宽的iERM光带,而通过OCT反映的视网膜病变情况,如病情分期、黄斑中心凹厚度以及椭圆体带的完整性等,对于随访、确定手术时机和判断预后等具有重要价值。相干光断层扫描血管成像术(optical coherence tomography angiography,OCTA)结合了OCT和血管成像的技术,在iERM患者眼中,由于黄斑前膜的牵引作用,OCTA的关键参数如黄斑中心凹无血管区(foveal avascular zone,FAZ)面积、血管扭曲程度和血管密度发生改变,可以在一定程度上评估患者的预后情况。OCT和OCTA技术的应用有助于更准确地诊断和管理黄斑前膜患者。

关键词: 特发性黄斑前膜, 相干光断层扫描, 相干光断层扫描血管成像

Abstract: Macular epiretinal membrane is a non-vascular fibroblast membrane located on the retinal inner surface in the macular area. Idiopathic macular epiretinal membrane (iERM) accounts for about 80%. Currently, optical coherence tomography (OCT) is the preferred diagnostic method for identifying iERM. OCT technology enables the early detection of the thickened and enhanced layer in the macular region associated with iERM. The information provided by OCT, such as the staging of the condition, central macular thickness, and integrity of the ellipsoid zone, plays a significant role in follow-up, determining the optimal timing for surgery and predicting prognosis. Optical coherence tomography angiography (OCTA) combines the technology of OCT and vascular imaging. In patients with iERM, OCTA images exhibit differences compared to those of normal eyes due to the traction caused by the epiretinal membrane on the retinal vasculature. Therefore, key parameters obtained through OCTA, such as the FAZ (foveal avascular zone) area, degree of vascular distortion, and vascular density, provide valuable insights for evaluating the prognosis of patients. The application of OCT and OCTA aids in more accurate diagnosis and management of patients with macular epiretinal membrane.

Key words: idiopathic macular epiretinal epithelium, optical coherence tomography, optical coherence tomography angiography