中心性浆液性脉络膜视网膜病变的光学相干断层成像分析

Optical coherence tomography of central serous chorioretinopathy

目的 :探讨中心性浆液性脉络膜视网膜病变 (centralserouschorioretinopathy ,CSC)光学相干断层成像 (opticalcoherencetomography ,OCT)的特征和临床应用。方法 :对临床诊断为急性期CSC患者 (即出现主观症状 4～ 8周之内 ) 4 7例 5 0只眼 ,经散瞳后进行OCT检查 ,并对病变图像进行分析和测量。结果 :急性期CSC患者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。病变范围 6 18～ 6 40 0 μm ,平均 (3185 0 1± 1495 2 1)μm ;高度 5 9～ 790 μm ,平均 (2 6 2 2 8± 175 2 0 ) μm。经统计学处理 ,表明CSC神经上皮层脱离范围、高度均与视力相关 (P <0 0 5 )。结论 :OCT是一种新型非侵入性的客观定量检查技术。通过OCT对所有急性期CSC眼表现的浆液性视网膜脱离病变的定量分析 ,表明它对CSC的诊断、鉴别诊断。

Objective:To evaluate the characteristic and clinical application of optical coherence tomography (OCT) during the acute phase of central serous chorioretinopathy (CSC).Methods:From Oct.1998 to Jun.2000,50 eyes of 47 patients (38 males, 9 females)with the clinical diagnosis of CSC during the acute phase were examined with OCT after pupil dilated, and the results were analyzed and measured. Results:OCT sections all demonstrated a vaulted elevation of the retina at the central fovea with the development of an optically clear space consistent with serous detachment of the neurosensory retina caused by subretinal fluid accumulation.Quantitative measurement showed the diameters of detachment were 618～6400(3185 01±1495 21)μm,the heights of detachment were 59～790(262 28±175 20)μm.Statistical analysis indicated the range and height of detachment were correlated with the vision( P<0 05 ).Conclusion:OCT is a new,noninvasive objective technique for quantitative examination of patients with CSC in the acute phase.It is useful in the diagnosis,differential diagnosis,quantitative estimation and inspection of the CSC