Optical coherence tomography to detect and manage retinal disease and glaucoma
Optical coherence tomography to detect and manage retinal disease and glaucoma
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DOI：
10.1016/s0002-9394(03)00792-x
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发表时间：
2004-01-01
影响因子：
4.2
通讯作者：
Caprioli, J
中科院分区：
文献类型：
--
作者：
Jaffe, GJ;Caprioli, J
目的：回顾光学相干断层扫描的基本原理，并描述其在视网膜疾病和青光眼的诊断和治疗中的应用。设计：视角。方法：文献综述。结果：光学相干断层扫描是一种无创成像技术，已越来越多地用于诊断和治疗各种视网膜疾病和青光眼。光学相干断层扫描 (OCT) 基于迈克尔逊干涉测量原理。从视网膜组织和参考镜反射的低相干光产生的干涉图案被处理成“A扫描”信号。多个 A 扫描信号对齐以产生二维图像，可以将其视为“体内组织学”的一种形式。光学相干断层扫描已用于识别黄斑裂孔，区分黄斑裂孔与模拟病变，识别板层黄斑裂孔、黄斑囊肿、玻璃体黄斑牵引、视网膜下液、色素上皮脱离和脉络膜新生血管。它可用于识别和量化黄斑水肿，并测量治疗后视网膜厚度的变化。 OCT 测定的黄斑厚度测量值与视力以及荧光素血管造影观察到的渗漏密切相关。光学相干断层扫描是一种准确且可重复的测量视网膜神经纤维层厚度的方法。特别是，当与其他视神经成像技术结合使用时，它可以用于区分青光眼眼和正常眼。尽管 OCT 很有用，但它也有其局限性。光学相干断层扫描设备价格昂贵，而且并非所有保险公司都会报销此程序。图像质量取决于操作员技术，并且在介质不透明的情况下可能会降低。用于青光眼应用的变化分析软件尚未完全开发出来，并且缺乏年龄、性别和种族特定的规范数据来比较眼睛与视网膜疾病和青光眼。在未来几年中，OCT 作为诊断和治疗视网膜疾病和青光眼的方法的作用可能会得到进一步明确，并且当前的许多局限性将被克服。 结论：光学相干断层扫描是一种有用的成像技术，可用于诊断和治疗各种视网膜疾病和青光眼。需要小心避免伪影和图像误解。
PURPOSE: To review basic principles of optical cohere ence tomography, and to describe its use in the diagnosis and management of retinal diseases and glaucoma.DESIGN: Perspective.METHODS: Literature review.RESULTS: Optical coherence tomography is a noninvasive imaging technique that has been used increasingly to diagnose and manage a variety of retinal diseases and glaucoma. Optical coherence tomography (OCT) is based on the principal of Michelson interferometry. Interference patterns produced by low coherence light reflected from retinal tissues and a reference mirror are processed into an "A-scan" signal. Multiple A-scan signals are aligned to produce a two,dimensional image that can be thought of as a form of "in vivo histology." Optical coherence tomography has been used to identify macular holes, to differentiate macular holes from simulating lesions, to identify lamellar macular holes, macular cysts, vitreomacular traction, subretinal fluid, pigment epithelial detachment, and choroidal neovascularization. It can be used to identify and quantify macular edema, and to measure retinal thickness changes in response to therapy. Macular thickness measurements determined by OCT correlate well with visual acuity and with leakage observed by fluorescein angiography. Optical coherence tomography is an accurate and reproducible method to measure retinal nerve fiber layer thickness. Particularly, when used in combination with other optic nerve imaging techniques, it can be used to differentiate glaucomatous eyes from normal eyes. Despite its usefulness, OCT has its limitations. Optical coherence tomography equipment is expensive, and not all insurance companies reimburse this procedure. Image quality is dependent on operator technique and can be degraded in the presence of media opacity. Change analysis software for glaucoma applications is not fully developed, and there is a scarcity of age, gender, and race-specific normative data upon which to compare eyes with retinal disease and glaucoma. In the next few years, it is likely that the role of OCT as a method to diagnose and manage retinal disease and glaucoma will be further defined, and many of the current limitations will be overcome.CONCLUSIONS: Optical coherence tomography is a useful imaging technique to diagnose and manage a variety of retinal diseases and glaucoma. Care is needed to avoid artifacts and image misinterpretation.