三维OCT联合眼底彩色照相评价中心性浆液性脉络膜视网膜病变

Three-dimensional optical coherence tomography and fundus photochromy in central serous chorioretinopathy

目的探讨三维OCT联合眼底彩色照相在中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)检查中的临床意义。方法采用OCT联合同步眼底彩色照相,观察30例(36眼)经荧光素眼底血管造影确诊的CSC患者渗漏点处的形态。结果30例36眼患者(47个渗漏点)中,OCT检查发现22眼(28个渗漏点)为神经上皮层脱离,1眼(2个渗漏点)为色素上皮层脱离,13眼(17个渗漏点)为神经上皮层脱离伴色素上皮层脱离。47个渗漏点中OCT上表现为典型色素上皮改变者36个(76.6%),其中色素上皮脱离者19个(40.4%),色素上皮隆起者17个(36.2%);眼底彩色照相发现有灰白色渗出者28个(59.6%),二者检出率差异无统计学意义(P>0.05)。在OCT或眼底彩色照相表现有阳性体征者42个(89.4%)。结论三维OCT联合同步眼底彩色照相作为一种无损伤性、非接触性检查技术,不但能定性定量检查和随访CSC,还能定位渗漏点,指导激光治疗。

Objective To study the characteristics and clinical significance of three-dimensional（3D） optical coherence tomography （OCT） along with simultaneously fundus photochromy in central serous chorioretinopathy（CSC）.Methods Thirty CSC patients （36 eyes and 47 leakage spots） diagnosed by fundus fluorescein angiography were treated with 3D OCT along with fundus photochromy to observe histological appearance at leakage spots.Results With OCT,22 eyes（28 leakage spots） showed serous neurosensory detachment,1 eye（2 leakage spots） appeared retinal pigment epithelial detachment and 13 eyes （17 leakage spots） combined neurosensory detachment with retinal pigment epithelial detachment in 36 eyes（47 leakage spots） with CSC;Among the 47 leakage spots,36（76.6%） had obvious retinal pigment epithelial changes,19 （40.4%） had pigment epithelial detachment,pigment epithelium of 17 （36.2%） swelled up.Twenty-eight had gray change on the fundus photochromy.Forty-two leakage spots had positive sign with OCT or fundus photochromy.There was no statistically significant difference between OCT and fundus photochromy（P〉0.05）.Conclusion The 3D OCT is useful as a non-invasive diagnostic technique for qualitative and quantitative examination of patients with CSC and can be used to locate leakage spots,objectively monitor the clinical course and guide laser photocoagulation.