炫彩成像在中心性浆液性脉络膜视网膜病变检查中的临床应用探讨

Clinical application of multicolor imaging in central serous chorioretinopathy

目的描述中心性浆液性脉络膜视网膜病变(CSC)在炫彩成像(MCI)上的临床特征,对比MC与常规眼底彩照两项检查发现CSC特征的有效性。方法选取2018年10月至2019年6月来我院就诊的CSC患者48例(48只眼)。每个患者常规接受眼底彩照(CFP)、荧光素眼底血管造影(FFA)、相关光层析成像术(OCT)以及MC检查。记录常规眼底彩照、标准炫彩成像以及无赤光、绿光、蓝光成像上的眼底特征,并加以统计分析。结果48例(48只眼)患者中,通过FFA和OCT发现视网膜下积液和视网膜色素上皮渗漏点48只眼,视网膜色素上皮受损31只眼。视网膜积液在MCI上的检出率为91.67%,IR为87.50%,GR为83.33%,显著高于在常规眼底彩照上的检出率(62.50%)(P<0.05).在荧光造影上发现的视网膜色素上皮渗漏点,在MCI上和IR上的检出率均为85.42%,显著高于眼底彩照上的检出率(27.08%)(P<0.05)。在荧光造影上所发现的视网膜色素上皮病损改变,在MCI上和IR上的检出率均分别为93.55%和90.32%,显著高于常规眼底彩照上的检出率(35.48%)。结论在诊断CSC的多模式成像的联合观察中,炫彩成像相比眼底彩照,能更有效识别渗漏点,更好地显示视网膜下积液的范围和边界。在炫彩成像图像上,尤其是IR上,更能有效识别视网膜色素上皮受损处的异常改变。因此,炫彩成像可以更好的观察眼底结构,在检查中浆的多模式成像中发挥更大的价值。

Objective To observe the clinical features of central serous chorioretinopathy(CSC)using multicolor imaging(MCI),and to compare the effectiveness of detecting CSC features using MCI and traditional color fundus photography(CFP).Methods A total of 48 participants(48 eyes)with CSC in our hospital from October 2018 to June 2019 were retrospectively recruited.All patients underwent CFP,fudus fluorescein angiography(FFA),optical correlation tomography(OCT)and MCI examinations.The fundus characteristics of CFP,standard MCI,infrared reflectance(IR),green reflectance(GR),blue reflectance(BR)were analyzed and calculated.Results Among the 48eyes of 48 patients,48 eyes with subretinal fluid(SRF)and retinal pigment epithelial(RPE)leakage point and 31 eyes with PRE damage were observed by FFA and OCT.The detection rate of SRF in standard MCI,IR and GR was 91.67%,87.50%and 83.33%,respectively,which was significantly higher than that in CFP(62.50%)(P<0.05).The detection rate of abnormal area corresponding to the RPE leakage point on FFA using standard MC and IR was the same(85.42%),which was significantly higher than CFP(27.08%)(P<0.05).Areas of the RPE damage on FFA were observed at the same location with the standard MCI and IR at a detection rate of 93.5%and 90.3%,respectively,which were significantly higher than CFP(35.48%)(P<0.05).Conclusions Regarding the observation using multi-mode fundus imaging in the diagnosis of CSC,the MC can identify the leakage point more effectively than CFP and also delineate the extent or boundaries of SRF more effectively.The MCI,particularly the IR channel,can identify areas of RPE damage more effectively than CFP.Therefore,the MCI can better observe the fundus,playing a more important role in multi-mode fundus imaging in the diagnosis of CSC.