中心性渗出性脉络膜视网膜病变的光学相干断层扫描图像特征

Optical coherence tomography features of central exudative chorioretinopathy

目的 观察中心性渗出性脉络膜视网膜病变 (central exudative chorioretinopathy,CEC)脉络膜新生血管 (choroidal neovascularization,CNV)的光学相干断层扫描 (optical coherence tomography,OCT)图像特征。 方法 对 4 1例发病时间从 1周～ 10个月的 CEC患者的 4 3只患眼进行荧光素眼底血管造影 (fundus fluorescein angiography,FFA)和 OCT检查 ,其中 2 7只患眼在 FFA检查的同时进行了吲哚青绿眼底血管造影 (indocyanine green angiography,ICGA)检查。对比分析其 CNV的 OCT和 FFA及ICGA图像特征。 结果 CEC的 OCT图像表现为边界清楚的 CNV(41.86 % )、边界不清的 CNV(30 .2 3% )、出血性色素上皮脱离 (pigment epithelium detachment,PED) (16 .2 8% )、伴有浆液性 (6 .98% )或出血性神经上皮脱离的 CNV(4.6 5 % ) 5种形态。其中以边界清楚的 CNV和边界不清的 CNV为主 ,共占 72 .0 9%。视网膜血管造影 ,能清楚确定 CNV的边界者 ,FFA、ICGA检查分别为 12、2 0只眼 ;OCT从视网膜断层切面上能清楚确定 CNV边界者 2 3只眼。FFA检查上典型的 CNV,OCT图像通常也表现为边界清楚的 CNV;FFA检查上非典型的 CNV,OCT图像表现为多种形态。 结论 CEC的 OCT图像特征以边界清楚的 CNV和边界不清的 CNV为主?

Objective To investigate the morphological features of choroidal neovascularization (CNV) in central exudative chorioretinopathy (CEC) using optical coherence tomography (OCT). Methods OCT and fundus fluorescein angiography (FFA) were performed in 41 cases (43 eyes) of CEC,and the course of CEC disease was from 1 week to 10 months. Twenty seven of 43 eyes were also examined by indocyanine green angiography (ICGA). Results OCT images revealed 5 kinds of morphological features of CEC: well defined CNV(41.86 %),poorly defined CNV(30.23 %),hemorrhagic pigment epithelium detachment (PED)(16.28 %), CNV companied with serous (6.98 %) or hemorrhagic neurosensory retina detachment (4.65 %). CNV mainly showed well defined and poorly defined CNV (72.09 %).In those eyes that could clear define the CNV boundary,there were 12 eyes on FFA examination and 20 eyes on ICGA examination which defined the boundary from retinal horizontal plane, while there were 23 eyes on OCT examination which defined the boundary from retinal vertical section. Classic CNV on FFA consistently presented with well defined boundaries on OCT ,whereas non classic CNV had a variable cross sectional appearance. Conclusions The OCT morphological features of CNV in CEC is mainly well defined CNV and poorly defined CNV; OCT examination can precisely observe the retinal and choriocapillaries pathological anatomy of CEC from retinal vertical section, in making the CEC diagnosis as an important complementary examination of FFA and ICGA which observe the focus from retinal horizontal plane.