后巩膜炎眼科影像学特征

Ophthalmic imaging features of posterior scleritis

目的:分析总结描述后巩膜炎的眼科影像学特征。方法:在我院2008-10/2013-06期间确诊的后巩膜炎患者16例21眼的临床资料进行回顾性分析,分析B超、眼底彩色照相、眼底荧光血管造影、CT结果,对后巩膜炎眼科影像学特征进行综合评价与分析。结果:所有患者均行B超检查,B超表现分为弥漫型和结节型两种,弥漫型表现为巩膜弥漫增厚,其后有筋膜囊水肿性低回声暗区与视神经相连,形成典型的"T"形征;结节型表现为巩膜结节型回声增强,内部结构较规则。FFA表现为动脉早期见斑驳状相对弱荧光,动静脉期出现多发针尖样强荧光,逐渐变大融合;晚期荧光素渗漏至视网膜下组织;视盘有不同程度的强荧光,边界欠清或不清。CT结果表现为眼球球壁增厚。结论:后巩膜炎好发于中青年女性患者,其眼科影像学的表现多变,以B超表现较有特异性;选择合理的眼科影像学检查手段,并结合临床表现,能够准确诊断后巩膜炎,避免漏诊和误诊现象的发生。

AIM： To analyze, summarize and describe ophthalmic imaging features of posterior scleritis. METHODS： Clinical data of 16 patients （21 eyes） with posterior scleritis diagnosed in our hospital from October 2008 to June 2013 were retrospectively analyzed. The results of type- B ultrasonic, fundus chromophotograph, fundus fluorescein angiography, CT were recorded for comprehensive evaluation and analysis of ophthalmic imaging features of posterior scleritis. RESULTS： All patients underwent type-B ultrasonic examination and manifested as diffuse and nodular types. The diffuse type showed diffusely thickened sclera and a dark hypoechoic area that connected with the optic nerve to form a typical ＂T＂-shaped sign, The nodular type showed scleral echogenic nodules and relatively regular internal structure. FFA showed that relatively weak mottled fluorescences were visible in the arterial early phase and strong multiple needle-like fluorescences were visible in the arteriovenous phase, which were then progressively larger and fused fluorescein was leaked to the subretinal tissue in the late phase; varying degrees of strong fluorescences with less clear or unclear boundaries were visible in the optic disk. CT results showed thickened eyeball wall. CONCLUSION： Posterior scleritis is common in young female patients, whose ophthalmic imaging features are varied and more specific in type-B ultrasonic. Selection of rational ophthalmic imaging examination method, combined with clinical manifestations, can accurately diagnose posterior scleritis and avoid the incidence ofmissed and delayed diagnosis.