SD-OCT观察CSCR形态学改变与视力的关系

Relationship between the morphologic changes of central serious chorioretinopathy and visual acuity by spectral-domain optical coherence tomography

目的：探讨急性中心性浆液性脉络膜视网膜病变（centralserious chorioretinopathy,CSCR）黄斑区形态学的改变与视力恢复的关系。方法：选取急性CSCR患者38例38眼,根据最佳矫正视力进行分组,第一组BCVA为1.0~0.6（logMAR 0~0.176）者17例（45%）,第二组BCVA为0.6~0.3（logMAR 0.176~0.477）者19例（50%）,第三组BCVA低于6/18（logMAR0.477）者2例（5%）。应用频ⅡOCT进行检查。结果：患者平均年龄42.50±5.41岁,平均logMAR视力为0.176±0.0185,RPE脱离21眼（55%）,其中单处脱离14眼（67%）,多处脱离7眼（33%）,RPE不规则凸起7眼（18%）,单纯RPE层颗粒状沉积5眼（13%）。平均神经上皮层脱离高度是259.11±128.78μm。神经上皮层脱离区外核层的厚度第一组为70.1±9.08μm,6mo后为66.5±8.13μm;第二组为81.6±8.16μm,6mo后为67.8±7.49μm;第三组为91.9±8.03μm,6mo后为58.6±7.26μm;差异均具有显著性。急性期光感受器层平均厚度为93.10μm,6mo后平均为75.69μm（P=0.012）。结论：在急性期CSCR视力与黄斑区神经上皮层脱离范围尤其是脱离高度及外核层的厚度有密切的关系,而色素上皮层脱离的类型、部位及是否存在纤维沉积与视力无明显关系。恢复期CSCR视力与外核层变薄有着显著地联系。

To evaluate the relationship between the morphologic changes of central serious chorioretinopathy （ CSCR） and recovery of visual acuity visual acuity （ VA） .METHODS： Thirty-eight eyes of thirty-eight patients with CSCR were studied and divided according to best corrected visual acuity （BCVA）. Group 1, n=17 （45%）, VA 6/6-6/9 （logMAR 0 ~0. 176）; Group 2, n=19（50%）, VA 6/9-6/18 （ logMAR 0. 176 ~ 0. 477 ）; Group 3, n= 2 （5%）, VA less than 6/18 （logMAR 0. 477）. All patients inspected by spectral - domain optical coherence tomography （ SD-OCT） .RESULTS： The mean age of the patients was 42. 50 ± 5. 41years, the mean logMAR VA was 0. 176 ± 0. 0185, retinal pigment epithelium （ RPE） detachments in 21 eyes （ 55%） , including single RPE detachments in 14 eyes （ 67%） , and multiple confluent RPE detachments in 7 eyes （33%）. Small bulge of RPE in 7 eyes （18%）, granular deposition epi-RPE in 5 eyes （13%）. The mean subretinal fluid height at the fovea was 259. 11 ± 128. 78μm. The average photoreceptor lengths were 70. 1 ± 9. 08μm, 81. 6 ± 8. 16μm, and 91. 9 ± 8. 03μm in groups 1, 2, and 3, respectively, the mean subretinal fluid height at the fovea was 66.5±8.13μm, 67.8±7.49μm, and 58.6±7.26μm after 6mo, respectively. The mean outer nuclear layer thickness during the active stage was 93. 10μm and it was 75. 69μm after 6mo （P=0. 012） CONCLUSlON： ln the acute CSCR, VA showed statistically significant association with greater dimensions of subretinal fluid-particularly, greater subretinal fluid height and thinning of the outer nuclear layer at the fovea. The type of pigment epithelium detachment （ PED ） , location, or fiber deposition has nothing to associate with VA. ln resolved CSCR, VA has a significant associated with a persistently thinner outer nuclear layer.