Ocular Surgery News U.S. Edition, June 10, 2012
According to Richard L. Lindstrom, MD optical coherence tomography has moved from being a tool primarily utilized by the retina subspecialist to one increasingly present in the comprehensive ophthalmologist’s office.
时域OCT (TD-OCT)是一种非接触式测试那t can be done by an ophthalmic technician to image the optic nerve, macula or retina. The OCT (SD-OCT), which is a higher-speed, higher-definition instrument that gives even better images, allowing resolution that includes individual cell layers including the retinal pigment epithelium (RPE), photoreceptors, as well as a larger area of the retina or macula. The newest SD-OCT algorithms even allow 3-D reconstructions.
在TD-OCT和SD-OCT中发生了新的趋势,以解释视网膜和黄斑厚度,RPE升高和德鲁森尺寸/体积。将来,预计甚至蜂窝代谢率也将是可衡量的。和类似的技术在前部门应用,诊断能力有很大的进步。
The classical abnormalities in dry age–related macular degeneration include drusen formation, pigment dispersion/clumping and focal atrophy of the RPE. Each of these findings can be observed, documented and measured with OCT. In addition, with SD-OCT, drusen size and volume can be measured, and the actual RPE cells at the edge of an area of geographic atrophy can be seen, allowing one to measure the rate of progression. Photoreceptor atrophy and changes in the choriocapillaris often accompany these changes and can be visualized. In wet AMD, one can visualize the area where abnormal vessels penetrate Bruch’s membrane, causing fluid or blood to accumulate under the RPE and resulting in a pigment epithelial detachment (PED) or fluid accumulation in the subretinal space or within the retina. The size and volume of a PED can be measured, as can the overlying retinal thickness, potentially allowing earlier diagnosis and, when treated, monitoring of the response to therapy.
对于白内障外科医生,术前筛选允许检测对壁球菌膜,玻璃体术牵引综合征,糖尿病黄斑水肿和稀有黄斑疾病等稀有性黄斑异常,导致适当的术前,术中和术后治疗和及时的患者咨询。术后黄斑厚度是一种非常有用的工具,可在后勤囊状神经色调水肿的诊断中,并且也有助于监测对治疗的反应。TD-OCT成像和视神经头部的SD-OCT成像正在成为青光眼早期诊断的关键组分,并在监测患者以获得早期进展的早期迹象。
Ophthalmology has always been heavily dependent on technology to enhance the diagnostic and treatment acumen of the clinician, and despite the cost of OCT acquisition in the face of increasing economic pressure; it is difficult to imagine a busy ophthalmic practice without OCT or SD-OCT in 5 years.
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