急性中心性浆液性脉络膜视网膜病变FFA与频域OCT图像对比研究

A comparative study on image of FFA and FD-OCT in acute central serous chorioretinopathy

目的观察急性中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)荧光素眼底血管造影(fundus fluorescein angiography,FFA)和频域光学相干断层扫描(frequency domain optical coherence tomography,FD-OCT)图像特征,对比研究2种检查方法定位病灶的一致性。方法回顾性分析79例急性CSC患者(81眼)的FFA和FD-OCT图像资料,观察患眼FFA荧光素渗漏点与FD-OCT中视网膜色素上皮(retinal pigment epithelium,RPE)异常改变的对应关系。结果 81眼急性CSC患眼中,FFA检查发现荧光素渗漏点86个,在FD-OCT图像上表现为视网膜色素上皮脱离(pigment epithelial detachment,PED)、小隆起、粗糙紊乱等RPE层异常改变。此外尚有13眼(16.05%)在荧光素渗漏点以外区域存在着低荧光、荧光染色、透见荧光,在FDOCT上RPE亦表现为PED、小隆起、粗糙紊乱混合存在。还有6眼(7.41%)无任何异常荧光区域,在FD-OCT上RPE也显示有PED、小隆起、粗糙紊乱等改变。结论急性CSC的FFA渗漏点与FD-OCT中RPE异常改变部位基本对应,而FFA渗漏点以外区域FD-OCT亦有RPE层异常改变,在急性CSC诊治中FD-OCT不可完全替代FFA。

Objective To observe and compare the image features and their correlation of fundus fluorescein anglograph （FFA） and frequency domain optical coherence tomography （FD-OCT） in acute central serous chorioretinopathy （CSC）. Methods The data of FFA and FD-OCT of 79 cases （81 eyes） with acute CSC were retrospective analyzed. The corresponding relations between leakage points on FFA and abnormal changes of retinal pigment epithelium （RPE） layer on FD-OCT were observed. Results Eighty-six leakage points were detected in 81 eyes on FFA, for which FD-OCT all showed abnormal changes of RPE layer, such as pigment epithelial detachment （ PED）, a small RPE layer protrusion and RPE layer irregulari- ty disorder. In addition, outside of the fluorescence leakage, they showed low fluo- rescence and fluorescence staining and window defect in 13 eyes （ 16.05% ） of 81 eyes. FD-OCT often showed PED,a small RPE layer protrusion and RPE layer irreg- ularity disorder mixed and exist at the same time. Outside of fluorescence leakage, which were no any abnormal fluorescence region, FD-OCT also showed the PED, a small RPE layer protrusion,RPE layer irregularity disorder in 5 eyes （7.41%） of 81 eyes. Conclusion Leakage points on FFA corresponds to abnormal changes of RPE layer on FD-OCT. However, outside of fluorescence leakage on FFA, FD-OCT also have abnormal changes of RPE layer, FD-OCT can not completely replace FFA in acute CSC.