中心性浆液性脉络膜视网膜病变频域光学相干断层扫描

Use of spectral-domam optical coherence tomography for observing the central serous chorioretinopathy

目的:探讨中心性浆液性脉络膜视网膜病变(CSC)形态学改变及其发病机制。方法:回顾性横断面观察研究,对43例(49眼)CSC患者进行FFA和频域光学相干断层扫描(SD-OCT)检查,并将两者结果对比观察。结果:呈典型FFA表现21只眼,OCT扫描均发现神经上皮脱离或色素上皮脱离或两者皆有。其中FFA中未发现任何异常荧光部位5只眼,在OCT中却可见局部色素上皮光带粗糙和小隆起。FFA中呈不典型的渗漏表现23只眼中,OCT扫描也发现神经上皮脱离或色素上皮脱离或两者皆有,其中局部视网膜色素上皮光带粗糙和小隆起表现8只眼。FFA中未见任何异常荧光的5只眼,其中OCT扫描却发现有只眼呈局限性浆液性神经上皮浅脱离,即视网膜的隐性渗漏。结论:CSC的发病机制可能为脉络膜循环障碍继发RPE损害。SD-OCT对FFA诊断和研究CSC有很好的补充甚至是替代作用。

Objective：To study the morphological changes and pathogenesis of the central serous chorioretinopathy （CSC）. Methods ：This was a retrospective cross-sectional observational study. Spectral-domain optical coherence tomography （SD-OCT） and fundus fluorescein angiography （FFA） were peformed in 43 cases （49 eyes） of CSC. Results：Neuroepithelial and/or retinal pigment epithelium detachment were found in 21 eyes with typical FFA and 23 eyes with non-typical leakage. Among 23 eyes with non-typical leakage we can find 8 eyes with rough surfaces of RPE. No fluorescence in 5 cases but shallow retinal neuroepithelial detachment leaking in 3 cases were found by SD-OCT. Conclusion：The pathogenesis of CSC may be choroid circulation disorders and secondary RPE damage. SD-OCT is an important complementary and even substitute examination of FFA for diagnosing and studying CSC .