中心性浆液性脉络膜视网膜病变的光学相干断层扫描图像

Optical coherence tomography of central serous chorioretinopathy

目的评价光学相干断层扫描（Optical Coherence Tomography,OCT）在中心性浆液性脉络膜视网膜病变（Central Serous Chorioretinopathy,CSC）患者急性期与恢复期的形态学特征。方法对临床诊断为单眼首次发病的CSC患者65例,急性期（即出现主观症状4~8周内）与恢复期分别行OCT检查。结果急性期OCT图像特征为累及黄斑中心凹的视网膜神经上皮层的拱形隆起与色素上皮层之间的浆液性弱反射暗区,主要表现为视网膜神经上皮层脱离、神经上皮层和色素上皮层同时脱离、色素上皮脱离三种不同形式。恢复期末次OCT表现为神经上皮层下液体完全吸收,部分患者黄斑中心凹厚度变薄。15例定期追踪观察的OCT均可动态地观察到液体的吸收和测量到神经上皮层脱离高度的减少。结论OCT能显示CSC患者的病变直观的图像并能进行定量的追踪观察,对随访病情的变化有重要的指导意义。

Objective To evaluate the morphological characteristic of optical coherence tomography （OCT） in acute and recovery phase of central serous chorioretinopathy （CSC）. Methods Sixty-five cases of CSC were examined by optical coherence tomography. OCT was performed in acute phase with subjective symptoms occurring in 4-8 weeks and in recovery phase, respectively. Results OCT in the acute phase of CSC showed a vaulted elevation in retina at the central fovea with an optically clear space which was consistent with serous detachment of neurosensory retina caused by subretinal fluid accumulation, manifested as detachment of neurosensory and retinal pigment epithelium and rupture of pigment epithelium. The last OCT in the recovery phase of CSC showed absorption of serous fluid in the neuroepithelium. The central fovea of macula became thinner in some patients. Regular follow-up OCT showed serous fluid absorption and decreased detachment of neuroepithelium in l5 patients. Conclusion OCT can show the direct images of CSC and quantitatively monitor the clinical course of serous retinal detachment, and is, therefore, of important significance for the change in CSC during follow-up.