多模式成像在匍行性脉络膜炎中的应用进展

Research advance in clinical application of multimode imaging in Serpiginous choroiditis

匍行性脉络膜炎(SC)是一种罕见的慢性特发性炎性疾病,主要侵犯视网膜色素上皮(RPE)和脉络膜毛细血管,以视盘周围青灰色或灰黄色的地图状病变为特征。病因不清,脉络膜毛细血管炎可能是其主要病理类型。根据眼底表现可分为视盘周围型、黄斑型、变异型SC。由于SC的临床表现丰富多样,且与急性后部多灶性鳞状色素上皮病变(APMPPE)、结核、视网膜弓形虫病和脉络膜缺血等表现类似,所以对不具有典型眼底改变的SC诊断仍然存在一定困难。随着科技的进步,像荧光素眼底血管造影、吲哚菁绿血管造影、眼底自身荧光及光相干断层扫描等多模式影像检查联合应用有助于SC的早期诊断、评估病变范围、活动性以及可能的并发症,且对于避免不必要的药物使用至关重要。

Serpiginous choroiditis(SC)is a rare,chronic-idiopathic inflammatory disease mainly involving choriocapillaris and the retinal pigment epithelium(RPE),characterized by grayish yellow geographic lesions.Pathogenesis is unclear,the choriocapillaris is a main pathology of SC.Based on clinical presentation,it can be classified into peripapillary,macular,and ampiginoustype.The clinical appearance of SC is varied and similar to those of acute posterior multifocal placoid pigment epitheliopathy(APMPPE),tuberculosis,toxoplasmosis and choroidal ischemia.So,it is still difficult to diagnose SC without typical fundus symptoms.With the development of science and technology,multimode imaging such asfundus fluorescein angiography,indocyanine green angiography,fundus autofluorescence and optical coherence tomography are helpful for the diagnosis of SC,assessment of lesion extent,activity,and complications.Besides,it s very important to avoid unnecessary drug use.