中心性浆液性脉络膜视网膜病变的谱域光学相干断层扫描特征

Spectral Domain Optical Coherence Tomography in Patients with Central Serous Chorioretinopathy

目的观察中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的谱域光学相干断层扫描(spectral domain optical coherence tomography,SD-OCT)图像特征。方法对临床上已确诊为CSC的34例(40只眼)患者进行SD-OCT和荧光素眼底血管造影(fundus fluorescein angiography,FFA)检查,分析其图像特征并对二者结果进行比较。结果 40只眼的SD-OCT检查结果显示,37只眼(92.5%)有黄斑区局限性神经上皮脱离,3只眼(7.5%)仅有色素上皮脱离。神经上皮脱离的37只眼中,9只眼(24.3%)感光细胞内外节结合部信号增强、增厚,28只眼(75.7%)信号减弱或消失;伴有色素上皮脱离20只眼(54.1%),伴有色素上皮层增厚、不规则或隆起12只眼(32.4%),仅有神经上皮脱离5只眼(13.5%)。3只眼SD-OCT与FFA均表现为色素上皮脱离者,二者色素上皮脱离位置和大小相一致。28只眼FFA表现为荧光渗漏点者,SD-OCT在相应位置均有色素上皮增厚、不规则、隆起或脱离。SD-OCT较FFA能发现更多的色素上皮脱离和神经上皮脱离。结论 CSC患者的SD-OCT多数在神经上皮脱离区内存在视网膜色素上皮的增厚、不规则、隆起或脱离,感光细胞内外节结合部信号多数减弱或消失。

Objective To study the clinical features of spectral domain optical coherence tomography （SD-OCT） scanning in patients with central serous chorioretinopathy （CSC）. Methods Thirty-four patients （40 eyes） with confirmed CSC underwent SD-OCT scanning and fundus fluorescein angiography （FFA）. Clinical findings in both examinations were analyzed and compared. Results As shown by SD-OCT, local neuro-retina detachments in macular areas were found in 37 of 40 eyes （92. 5% ）, and retinal pigment epithelium （RPE） de- tachments without neuro-retina detachments were found in 3 eyes （7.5%）. In the eyes with neoro-retina detach- ments, high and thickened signals of photoreceptor inner segment/outer segment （IS/OS） junction were found in 9 eyes （24. 3% ）, and low or disappeared signals of IS/OS junction were found in 28 eyes （75.7%）. Twenty of 37 eyes （54. 1% ） with neuro-retina detachments had RPE detachments, 12 eyes （32. 4% ） had small RPE elevations or thickened RPE layer. RPE detachments in both SD-OCT and FFA in 3 eyes kept consistent. In 28 eyes, RPE lesions in SD-OCT were found in the same area of the fluorescein leakage spots in FFA. More RPE detachments and neuro-retina detachments were found in SD-OCT than in FFA. Conclusions Small RPE elevations, thickened RPE layer, or RPE detachments can be found in the retinal detachment areas by SD-OCT in most CSC patients. Low or disappeared signals may exist in the IS/OS junction.