光学相干断层扫描结合眼底检查观察产后妊娠高血压疾病眼底病变

Optical coherence tomography combined with fundus examination for observation of fundus changes in postpartum women with pregnant hypertensive disorders

摘要:

目的  通过光学相干断层扫描（OCT）结合眼底检查观察产后妊娠高血压疾病（以下简称妊高征）疾病眼底病变。方法  产后妊高征48例患者行眼部检查，包括视力、验光、裂隙灯检查、眼底检查、OCT检查、眼底照相检查；部分患者行眼底荧光血管造影检查。结果  ①48例患者96只眼中OCT检查异常72只眼（75.00%），其中视网膜神经上皮层浆液性脱离40只眼（55.56%），色素上皮层及椭圆体带改变22只眼（30.56%），其他改变如视盘水肿、视网膜出血等10只眼（13.88%）。②48例患者96只眼眼底检查，其中Ⅰ期4只眼（4.17%）；Ⅱ期12只眼（12.50%）；Ⅲ期80只眼（83.33%）。③将妊高征患者产前妊高征分级和产后眼底检查做等级相关性检验，发现眼底检查结果与妊高征分级呈正相关（C=0.545，χ2=56.991，P =0.000）；将妊高征患者产后就诊于眼科时的血压分级和眼底检查做等级相关性检验，发现两者无相关性（C=0.117，χ2=2.633，P =0.853）；眼底检查与OCT检查结果做等级相关性检验，发现两者呈正相关（C=0.324，χ2=20.130，P =0.000）。结论  对妊高征患者行产后眼部检查非常重要，眼底结合OCT检查可以更有效地发现妊高征眼底病变。

关键词:

妊娠高血压疾病;视网膜病变;光学相干断层扫描

Abstract:

Objective To observe fundus lesions in postpartum women with pregnant hypertensive disorders by optical coherence tomography (OCT) combined with fundus examination. Methods Forty-eight patients with postpartum hypertensive disorders complicating pregnancy accepted eye examinations including visual acuity, refraction, slit lamp examination, fundus examination, OCT and fundus camera inspection. Results Of the 96 eyes in the 48 patients, 72 eyes (75.00%) were abnormal in OCT examination, among which 40 eyes (55.56%) showed neurosensory serous retinal detachment, 22 eyes (30.56%) had pigment epithelium and ellipsoidal zone change, 10 eyes (13.88%) had other changes as optic disc edema and retinal hemorrhage. Fundus examination revealed stageⅠ in 4 eyes (4.17%), stageⅡ in 12 eyes (12.50%) and stage Ⅲ in 80 eyes (83.33%). Rank correlation test of prepartrum pregnancy-induced hypertension syndrome(PIHS) classification and postpartrum fundus examination in the women with PIH revealed a positive correlation between the result of fundus examination and PIHS classification (C = 0.545, χ2 = 56.991, P = 0.000). There was no correlation between blood pressure grade of the PIH women at the time of postpartrum eye examination and the result of fundus examination (C = 0.117, χ2 = 2.633, P = 0.853). Fundus and OCT findings had a positive correlation (C =0.324, χ2 = 20.130, P = 0.000). Conclusions Postpartrum eye examination is very important for women with PIH. Fundus examination combined with OCT examination can more effectively reveal retinopathy of PHIS.

Key words:

pregnancy-induced hypertension; retina disease; optical coherence tomography