【摘要】  目的 本研究应用光学相干断层扫描（OCT）观察激光光凝治疗黄斑水肿前后后极部视网膜厚度的变化，评价OCT在黄斑水肿治疗随访中的价值。方法 格栅样光凝治疗的患者21例（28眼）于治疗前和治疗后3个月行OCT检查，测量以黄斑中心凹为中心4 mm范围内视网膜厚度。结果 黄斑中心凹1 mm圆内和1～2.22 mm圆环内平均视网膜神经上皮层厚度激光治疗前及3个月后差异有统计学意义（P<0.05），2.22～3.45 mm圆环内平均厚度差异无统计学意义（P>0.05）。结论 治疗3个月后黄斑区视网膜神经上皮层厚度降低，并且越接近黄斑中心凹处，格栅样光凝的作用越明显。OCT在黄斑水肿治疗的随访观察中可发挥重要作用。

【关键词】  光学相干断层扫描；黄斑水肿；激光光凝；视网膜厚度

    Observation of retinal thickness before and after laser photocoagulation in macular edema

    LIN Song,HU Bo-jie,SUN Hui-min.Tianjin Medical University Eye Center,Tianjin 300070,China

    ［Abstract］  Objective  To observe the changes of the central retinal thickness before and after photocoagulation using the Optical Coherence Tomography （OCT）in macular edema.Methods  OCT was performed in 21 patients （28 eyes） before and 3 months after grid photocoagulation.Measurement was done for the average retinal thickness within a diameter of 4 mm to the fovea center.Results  There was significant statistical difference between pre-treatment and 3 months of the average retinal thickness within a diameter of 1 mm and 1~2.22 mm area（P<0.05）.In the 2.22~3.45 mm diameter zone,the difference before and after the treatment was not statistically significant（P>0.05）.Conclusion  The thickness of the sensory retina at the macular area decreased after the grid laser treatment at the post treatment period of 3 months.The closer to the fovea,the more therapeutic effect was shown for the treatment.OCT play a very important role in the treatment and follow up for macular edema.

    ［Key words］  optical coherence tomography；macular edema；laser photocoagulation；retinal thickness

    黄斑水肿（macular edema,ME）是一种常见的黄斑病变，引起黄斑水肿的常见病因有：糖尿病视网膜病变（diabetic retinopathy,DR）、视网膜静脉阻塞（retina vein occlusion,RVO）、视网膜血管炎、葡萄膜炎、黄斑前膜、内眼手术后等［1］。黄斑水肿的主要临床表现是视力随病变的严重程度及时间下降，这严重地损害患者的生活质量。因此，早期诊断治疗黄斑水肿及对治疗进行随访观察具有重要意义。光学相干断层扫描（optical coherence tomography,OCT）可将黄斑部的断层结构以伪彩色的图像显示出来，并活体测量黄斑的厚度。其检查方便，无创伤、可重复性好，无特殊禁忌证。

    本研究应用OCT观察黄斑区格栅样光凝治疗黄斑水肿前后视网膜厚度的变化，评价OCT在黄斑水肿治疗随访观察中的价值，以期有效地指导临床治疗。

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