急性中心性浆液性脉络膜视网膜病变FD-OCT影像特征及与最佳矫正视力的关系

FD-OCT Imaging Features of Acute Central Serous Chorioretinopathy and Its Relationship with Best Corrected Visual Acuity

目的研究急性中心性浆液性脉络膜视网膜病变(CSC)患者眼底荧光血管造影(FFA)渗漏点处视网膜色素上皮(RPE)层频域光学相干断层成像(FD-OCT)影像特征及最佳矫正视力(BCVA)与黄斑区形态学改变的关系。方法回顾性分析急性CSC患者32例(33眼)FFA早期荧光素渗漏点类型、渗漏点处RPE层FD-OCT影像特征及BCVA与黄斑中心凹神经上皮层脱离高度、宽度、黄斑中心凹厚度的相关性。结果33只患眼中26眼FFA检查发现典型荧光素渗漏点32个,22个渗漏点表现为墨渍型,6个渗漏点表现为喷出型,4个渗漏点表现为色素上皮脱离(PED)荧光着染,另外7眼未发现渗漏点。32个渗漏点在FD-OCT图像上,共19个(59.4%)出现RPE异常,PED有13个(40%),RPE层小隆起4个(12%),RPE层粗糙紊乱2个(6%)。BCVA与黄斑中心凹神经上皮层脱离高度差异有统计学意义(r=-0.449,P=0.009);BCVA与黄斑中心凹神经上皮层脱离水平宽度差异有统计学意义(r=-0.354,P=0.043);黄斑中心凹神经上皮层脱离高度与神经上皮层脱离水平宽度差异有统计学意义(r=0.539,P=0.001);BCVA与黄斑中心凹厚度差异有统计学意义(r=0.470,P=0.006)。结论急性CSC患者FFA荧光素渗漏点处多数存在RPE异常改变,BCVA与黄斑中心凹神经上皮层脱离高度、宽度呈负相关,与黄斑中心凹厚度及神经上皮层脱离高度与宽度呈正相关。

Objective To study the imaging characteristics of the retinal pigment epithelium(RPE)layer at the leakage point of fundus fluorescein angiography(FFA)in patients with acute central serous chorioretinopathy(CSC),the relationship of best corrected visual acuity(BCVA)and morphological changes in the macular area.Methods The early-stage leakage point type and imaging characteristics of FD-OCT for leakage point in 32 patients with CSC(33 eyes),the correlation of BCVA and retinal neuroepithelium detachment height,width,thickness of macular fovea were retrospectively analysed.Results Thirty-two typical fluorescein leakage points were found in 26 eyes of 33 suffering eyes by FFA examination.Twenty-two leakage points showed inklot diffusion,6 leakage points showed eruptive fluorescein leakage,4 leakage points showed pigment epithelial detachment(PED)fluorescein dyeing,7 eyes showed non-obvious fluorescein leakage.Among 32 fluorescein leakage points,a total of 19(59.4%)had abnormal RPE,FD-OCT showed PED in 13 leakage points(40%),a small RPE protrusion in 4 leakage points(12%),RPE irregularity disorder in 2 leakage points(6%).BCVA and height of retinal neuroepithelium detachment at macular fovea:r=-0.449,P=0.009.BCVA and width of retinal neuroepithelium detachment at macular fovea:r=-0.354,P=0.043.Height and width of retinal neuroepithelium detachment at macular fovea:r=0.539,P=0.001.BCVA and macular fovea thickness:r=0.470,P=0.006.Conclusion Most patients with acute CSC have abnormal RPE changes at the FFA fluorescein leakage point,there is a negative correlation between BCVA and height and width of retinal neuroepithelium detachment at macular fovea,there is a positive correlation between BCVA and macular fovea thickness and between height and width of retinal neuroepithelium detachment at macular fovea.