荧光素眼底血管造影下中心性浆液性脉络膜视网膜病变患者眼球后动脉血流动力学特征

Hemodynamic Characteristics of the Posterior Cerebral Artery in Fundus Fluorescein Angiography of Patients with Central Serous Retinopathy

目的探讨荧光素眼底血管造影(FFA)下中心性浆液性脉络膜视网膜病变(CSC)患者眼球血流动力学特征。方法选择2012年6月至2015年6月沈阳市皇姑区第四人民医院收治的300例(321眼)CSC患者作为研究对象,另选择同期在医院体检的健康人群50例(100眼)作为对照组。两组受试对象均采用彩色多普勒超声检查眼球后动脉血流动力学;CSC患者行FFA检查,观察视网膜色素上皮渗漏点的发生部位及形态特征。结果300例患者FFA检查共发现356处荧光渗漏灶,其中345处位于上下血管弓内,鼻上象限渗漏灶占33.9%(117/345),鼻下象限占24.1%(83/345),颞上象限占25.2%(87/345),颞下象限占16.8%(58/345)。314处渗漏灶位于黄斑中心3 mm半径内,距黄斑中心越近,渗漏灶越多,其中半径<1 mm内渗漏灶发生率为46.2%(145/314),半径1~<2 mm为36.0%(113/314),半径2~<3 mm为17.8%(56/314)。356处荧光渗漏灶中,喷出型渗漏灶发生率41.0%,扩散型为27.0%,微渗漏型为25.8%,混合型为6.2%。CSC组颞侧睫状后动脉收缩期峰值血流速度、舒张末期血流速度显著低于对照组[(12.5±0.8)cm/s比(15.6±1.3)cm/s,(3.61±0.22)cm/s比(5.12±0.44)cm/s](P<0.05)。结论 FFA检查所表现出的图像特征能够为CSC的诊断、治疗提供依据,而联合超声检查脉络膜血流动力学能够为准确、完整诊断CSC提供有用的信息。

Objective To explore the hemodynamic characteristics of the posterior cerebral artery in fluorescein fundus angiography（ FFA） of patients with central serous chorioretinopathy（ CSC）. Methods A total of 300 cases（ 321 eyes）CSC patients treated in Shenyang Fourth People＇ s Hospital from Jun. 2012 to Jun. 2015 were included as the research objects,another 50 cases（ 100 eyes） healthy people for health examination during the same period were included as a control group. Two groups received color Doppler ultrasound examination of blood flow dynamics of the eyeball,FFA examination was done on CSC patients,and the location and morphology of retinal pigment epithelial leakage were observed. Results Among 300 patients detected by FFA,356 fluorescent leakage lesions were found,including 345 of them located in the upper and lower blood vessels,and nasal superior quadrant accounted for 33. 9%（ 117 /345）,nasal inferior quadrant accounted for 24. 1%（ 83 /345）,superior temporal quadrant accounted for 25. 2%（ 87 /345）,inferior temporal quadrant accounted for 16. 8%（ 58 /345）. 314 fluorescent leakages located in the 3 mm radius of the macular center,the closer to the center of the macular,the more leakage. The leakage rate in the range of less than 1 mm was 46. 2%（ 145 /314）,1 〈2 mm 36. 0%（ 113 /314） and r 2 ~ 〈3 mm 17. 8%（ 56 /314）. In the 356 fluorescent leakages,jet type leakage accounted for 41. 0%（ 146 /356）,diffusion type 27. 0%（ 96 /356）,micro leakage type 25. 8%（ 92 /356）,mixed type 6. 2%（ 22 /356）. Peak systolic velocity（ 12. 5 ± 0. 8） cm / s,end diastolic velocity（ 3. 61 ± 0. 22） cm / s in the CSC group were significantly lower than those in the control group[（ 15. 6 ± 1. 3） cm / s,（ 5. 12 ± 0. 44） cm / s]（ P〈0. 05）. Conclusion FFA examination showed that the image features can provide the basis for the diagnosis and treatment of CSC,when combined with ultrasound examination of choroidal hemodynamics it can provide useful information for the accurate and complete diagnosis of CSC.