The Diagnostic Value Of The Optical Coherence Tomography(OCT) In The Early Central Retinal Artery Occlusion

Objective: To study the diagnostic value of the optical coherence tomography in the central retinal artery occlusion(mainly in early central retinal artery occlusion).Methods :To collect patients who were examined macular edema from September 2013 to July 2015 at the First Affiliated Hospital of Medical College of Shihezi university. By fundus fluorescein angiography(FFA),the patients total of 79 cases with 90 eyes were divided into the case group which include 30 cases with central retinal artery occlusion(CRAO), All the CRAO patients were ill within 2 weeks.the control group which include 30 cases with central retinal vein occlusion(CRVO) and 19 cases with 30 eyes with diabetic macular edema(DME). All of the patients were treated with macular OCT scan,(1) to measure the thickness of the macular central pits between the inner limiting membrane to the pigment epithelium layer. In the following referred to the central macular foveola thickness.(2)On OCT scan images, We observed that most of the CRAO patients were able to maintain a macular central depression, whereas the majority of CRVO and DME patients with macular central depression became shallow or disappeared, or even to the vitreous body. In order to describe the relationship between the macular foveal pit and on both sides of the retina, ease of presentation,We through the center point of the central macular foveola do perpendicular to the pigment epithelium layer,Connect the center point of the central macular foveola and nasal macular pits ranging 200 um do a straight line,Measure the angle formed by the vertical and the straightl line,In the following referred to as the angle.TO Statistic and analysis the measured data.Compared the two groups of the mean data using independent sample t-test, with the level of significance set at P <0.05.Results :1.The main findings of the macular edema of this study in the OCT scan were:the cystoids macular edema; Subcutaneous effusion of retina; Retinal inner cell edema. 2. the case group and the control group have significant differences in macular foveola thickness and the angle(P<0.05). 3.Draw ROC curve through the measured macular thickness, the area under the ROC curve was 0.912, the optimal critical value of macular central thickness of fovea to diagnose the central retinal artery occlusion was 205.0μm, the point sensitivity was 0.900,the Specificity was 0.867,the Youden index was 0.767;Draw ROC curve through the measured angle,the area under the ROC curve was 0.966, the optimal critical value of angle to diagnose the central retinal artery occlusion was 72。,the point sensitivity was 0.97,the Specificity was 0.90,the Youden index was 0.87. Two kinds of diagnosis methods all show that OCT has good diagnostic value for central retinal artery occlusion, But the measurement Of angle sensitivity and specificity is higher than the the measurement of macular fovea thickness, that is more accurate.Conclusion :The optical coherence tomography(OCT) has a good diagnostic value in the central retinal artery occlusion,Can be used as an important auxiliary diagnostic tool outside fluorescein fundus angiography,To provide objective evidence for the clinical diagnosis of central retinal artery occlusion.