|
３其他应用
3.1青光眼手术前后房角和滤过泡的评价 原发性闭角型青光眼是世界范围内重要的致盲眼病，对这类患者证实有效的方法是LPI。Memarzadeh等[20]分别用Visante OCT及前房角镜对10例（10眼）LPI术前术后的前房形态进行检查，结果表明LPI术后OCT的成像具有客观性、定量性，提出在进一步研究中应加大样本量，了解OCT的其他用途[21]。 Singgh等[22]曾用Visante OCT观察了激光缝线松解术前术后、小梁切开术后滤过泡的形态学变化。
3.2白内障手术角膜透明切口的评价 在当今的白内障超声乳化手术中，角膜透明切口手术仍然是最流行的手术切口，Calladine等[23]用Visante OCT对术后1h的白内障患者的角膜透明切口进行观察，观察指标包括切口的长度、平均切口角度以及切口构建特征（外切口哆开、内切口哆开、内皮错位、与后弹力层局部脱离和切口失对合），分析这些特征与眼压的关系，结果表明低眼压更常发生这些特征，这些特征是发生眼内炎重要的危险因素。 Fine等[24]应用Visante OCT观察白内障术后透明角膜切口的形态学和愈合情况。
3.3其他 Visante OCT配合特定的软件可用于测量前房的容积[25]；在角膜水肿的情况下，OCT可用于观察前房内的青光眼阀的小管[26]； Bakoff等[27]在静态眼没有调节的情况下，用前节OCT测量前节参数与年龄的关系，显示在不同的调节状况下，前节参数随年龄和调节的不同而有所改变。
总之，Visante OCT在眼前节的临床和科研中的应用尚处于初始阶段，但较之现有的眼前节成像系统，Visante OCT具有非接触性、无损伤性的、重复性好、测量范围广、获取图像快等特点，巩膜突在OCT图像中表现为高反射信号区，容易辨认。Visante OCT日益成为眼前节的主要检测工具。费用较高成为限制其广泛应用的一个因素，另外，Visante OCT不能很好地观察睫状体，房角隐窝在部分受试者中不能很好地定义[10]。对于角膜周边区域[3]，Visante OCT信号比较弱，厚度测量较不可靠。进一步提高分辨率和扫描光束的组织穿透力，开发自动化程度更高的处理软件，减少人为测量和操作的误差，建立眼前节OCT检查结果的正常参考值和参考图谱是今后需解决的问题。Visante OCT将成为前房角检查、角膜屈光手术、人工晶状体手术等方面主要的检查和评价工具。
【参考文献】
1 Ji BL. Srgnificance of retinal nerve fiber layer thickness measured by cptical conherence tomography in the early diagnosis of glaucoma. Int J Ophthalmol(Guoji Yanke Zazhi)2007;7(4):10191021
2 Wu M, Ye J, Sun Q, et al. Comparision between SLOCT and A wltrasound in measuring anterior choumber depth. Int J Ophthalmol(Guoji Yanke Zazhi)2007;7(5):13411342
3 Li Y，Shekhar R，Huang D. Corneal pachymetry mapping with highspeed optical coherence tomography. Ophthalmology2006;113(5):792799
4马凯,王光璐.光学相干断层照相及其在眼科的应用.中华眼底病杂志1999;1(1):5759
5 Dada T, Sihota R, Gadia R, et al. Comparison of anterior segment optical coherence tomography and ultrasound biomicroscopy for assessment of the anterior segment. J Cataract Refract Surg2007;33(5):837840
6孙冰,孙思勤.相干光断层扫描在眼前节的应用.国际眼科纵览2006;30(5):289291
7 Huang D，LI Y，Radhakrishnan S．Optical coherence tomography of the anterior segment of the eye. Ophthalmol Clin North Am2004;17:16
8 Li EY, Mohamed S, Rao SK, et al. Agreement among 3 methods to measure corneal thickness：ultrasound pachymetry， orbscan 2， and visante anterior segment optical coherence tomography. Ophthalmology2007;114(10):18421847
9张立华，贾亚丁，李晋水．超声角膜测厚仪和Orbscan测量LASIK术前角膜厚度的比较．山西医药杂志2006;4(4):346347
10 Konstantopoulos A, Hossain P, Anderson DF. Recent advances in ophthalmic anterior segment imaging；a new era for ophthalmic diagnosis？ Br J Ophthalmol2007;91(4):551557
11 Zhao PS, Wong TY, Wong WL, et al. Comparison of central corneal thickness measurements by visante anterior segment optical coherence tomography with ultrasound pachymetry. Am J Ophthalmol2007;143(6):10471049
12 Radhakrishnan S, Goldsmith J, Huang D, et al. Comparison of optical coherence tomography and ultrasound biomicroscopy for detection of narrow anterior chamber angles. Arch Ophthalmol2005;123(8):10531059
13 Nolan WP, See JL, Chew PT, et al. Detection of primary angle closure using anterior segment optical coherence tomography in asian eyes. Ophthalmology2007;114(1):3339
14 Radbakrisbnan S，See J, Smith SD, et al. Reproducibility of anterior chamber angel measurements obtained with anterior segment optical coherence tomography. Invest Ophthalmol Vis Sci2007;48(8):36833688
15 Nemeth G, Vajas A, Tsorbatzoglou A, et al. Assessment and reproducibility of anterior chamber depth measurement with anterior segment optical coherence tomography compared with immersion ultrasonography.
J Cataract Refract Surg2007;33(3):443447
16 Bakoff G, Jitsuo Jodai H, Bourgeon G. Measurement of the internal diameter and depth of the anterior chamber：IOLmaster versus anterior chamber optical coherence tomographer. J Cataract Refract Surg2005；31(9):17221728
17 Kohnen T, Thomala MC, Cichocki M, et al. Internal anterior chamber diameter using optical coherence tomography compared with whitetowhite distances using automated measurements. J Cataract Refract Surg2006;32(11):18091813
18 Li Y, Netto MV, Shekhar R, et al. A longitudinal study of LASIK flap and stromal thickness with highspeed optical coherence tomography. Ophthalmology2007;114(6):11241132
19 Bakoff G. Anterior segment OCT and phakic intraocular lenses: A perspective. J Cataract Refract Surg2006;32(11):18271835
20 Memarzadeh F, Li Y, Chopra V, et al. Anterior segment optical coherence tomography for imaging the anterior chamber after laser peripheral iridotomy. Am J Ophthalmol2007;143(5)：877879
21 Cao SJ, Zhang SS, Wang L. Advance of retinal nerve fiber layer thickness measurement using optical coherence tomography on the diagnosis of glaucoma. Int J Ophthalmol(Guoji Yanke Zazhi)2008;8(8):16341636
22 Singh M, Aung T, Friedman DS, et al. Anterior segment optical coherence tomography imaging of trabeculectomy blebs before and after laser suture lysis. Am J Ophthalmol2007;143(5):873875
23 Clladine D, Packard R. Clear corneal incision architecture in the immediate postoperative period evaluated using optical coherence tomography. J Cataract Refract Surg2007;33(8):14291435
24 Fine IH, Hoffman KS, Packer M. Profile of clear corneal cataract incisions demonstrated by ocular coherence tomography. J Cataract Refract Surg2007;33(1)：9497
25 Wang NL, Wang BS, Zhai GS, et al. A method of measuring anterior chamber volume using the anterior segment optical coherence tomographer and specialized software. Am J Ophthalmol2007;143(5):879881
26 Sarodia U, Sharkawi E, Hau S, et al. Visualization of aqueous shunt position and patency using anterior segment optical coherence tomography. Am J Ophthalmol2007;143(6):10541056
27 Bakoff G, Lutun E, Ferraz C, et al. Static and dynamic analysis of the anterior segment with optical coherence tomography. J Cataract Refract Surg2004;30(9):18431850 上一页 [1] [2] |
