应用光学相干断层扫描血管成像技术评价中心性浆液性脉络膜视网膜病变视网膜及脉络膜的微循环变化(英文)

Evaluation of the Microcirculation Changes in Retina and Choroid of Central Serous Chorioretinopathy by Using Optical Coherence Tomography Angiography

【目的】应用光学相干断层扫描血管成像(OCTA)技术定量分析中心性浆液性脉络膜视网膜病变(CSC)视网膜脉络膜的微循环变化。【方法】经常规眼科临床检查,眼底荧光血管造影(FFA)、吲哚菁绿血管造影(ICGA)等方法确诊CSC患者61例67眼。选取年龄、屈光匹配的正常人15名、30眼作为正常对照组。对OCTA检测结果进行比较,分析CSC患者视网膜脉络膜微循环的特点。【结果】CSC患眼视网膜表层血流密度(VDSR)和视网膜深层血流密度(VDDR)均低于正常眼,但差异无显著性意义(P=0.325,P=0.056)。CSC患眼脉络膜浅层血流密度(VDSC)明显低于正常对照组,差异有显著性意义(P<0.001)。经亚组分析,慢性CSC组中VDSR、VDDR均显著低于正常对照组(P=0.042,P=0.037),而急性CSC组中VDSR、VDDR与正常对照组无显著性差异。【结论】本研究发现CSC患眼存在眼底微循环异常,脉络膜浅层血流密度低于正常眼,并首次发现了慢性CSC视网膜表层和深层毛细血管血流密度低于正常眼,提示病史较长的患眼微循环异常不仅累及脉络膜血管而且累及视网膜血管。

【Objective】 To evaluate the microcirculation changes in retina and choroid of central serous chorioretinopathy（CSC）by using optical coherence tomography angiography（OCTA）.【Methods】A retrospective study was performed in 67 eyes of 61 patients with CSC diagnosed by conventional eye examination,fundus fluorescein angiography（FFA）and indocyanine green angiography（ICGA）,30 eyes of 15 age matched healthy people were selected as normal control group. OCTA was performed to study the microcirculation within the chorioretinal layers.【Results】The vessel density of superficial retina（VDSR）and deep retina（VDDR）layers in CSC eyes were lower than that in normal eyes,but the difference was no statistical significance（P = 0.325,P = 0.056）. The vessel density of superficial choroid（VDSC）layer in CSC eyes was significantly lower than control group. In subgroup analysis,the value of VDSR,VDDR in chronic group were lower than that of the control group,and the difference was statistically significant（P = 0.042,P =0.037）;While there was no statistical differences in VDSR,VDDR between acute group and control group.【Conclusion】Our study found that the abnormal microcirculation in CSC was existed. The VDSC in CSC was decreased. Furthermore,to our knowledge,the VDSR and VDDR were firstly observed to be attenuated in chronic CSC. This indicated that the microcirculation abnormality may involve the retina as well as superficial choroid in case with longer course of disease.