Spectral Domain Optical Coherence Tomography in Patients with Central Serous Chorioretinopathy
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摘要:
目的 观察中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy, CSC)的谱域光学相干断层扫描(spectral domain optical coherence tomography, SD-OCT)图像特征。 方法 对临床上已确诊为CSC的34例(40只眼)患者进行SD-OCT和荧光素眼底血管造影(fundus fluorescein angiography, FFA)检查, 分析其图像特征并对二者结果进行比较。 结果 40只眼的SD-OCT检查结果显示, 37只眼(92.5%)有黄斑区局限性神经上皮脱离, 3只眼(7.5%)仅有色素上皮脱离。神经上皮脱离的37只眼中, 9只眼(24.3%)感光细胞内外节结合部信号增强、增厚, 28只眼(75.7%)信号减弱或消失; 伴有色素上皮脱离20只眼(54.1%), 伴有色素上皮层增厚、不规则或隆起12只眼(32.4%), 仅有神经上皮脱离5只眼(13.5%)。3只眼SD-OCT与FFA均表现为色素上皮脱离者, 二者色素上皮脱离位置和大小相一致。28只眼FFA表现为荧光渗漏点者, SD-OCT在相应位置均有色素上皮增厚、不规则、隆起或脱离。SD-OCT较FFA能发现更多的色素上皮脱离和神经上皮脱离。 结论 CSC患者的SD-OCT多数在神经上皮脱离区内存在视网膜色素上皮的增厚、不规则、隆起或脱离, 感光细胞内外节结合部信号多数减弱或消失。 -
关键词:
- 中心性浆液性脉络膜视网膜病变 /
- 谱域光学相干断层扫描 /
- 荧光素眼底血管造影 /
- 视网膜色素上皮
Abstract:Objective To study the clinical features of spectral domain optical coherence tomography (SD-OCT) scanning in patients with central serous chorioretinopathy (CSC). Methods Thirty-four patients (40 eyes) with confirmed CSC underwent SD-OCT scanning and fundus fluorescein angiography (FFA). Clinical findings in both examinations were analyzed and compared. Results As shown by SD-OCT, local neuro-retina detachments in macular areas were found in 37 of 40 eyes (92.5%), and retinal pigment epithelium (RPE) detachments without neuro-retina detachments were found in 3 eyes (7.5%). In the eyes with neoro-retina detachments, high and thickened signals of photoreceptor inner segment/outer segment (IS/OS) junction were found in 9 eyes (24.3%), and low or disappeared signals of IS/OS junction were found in 28 eyes (75.7%). Twenty of 37 eyes (54.1%) with neuro-retina detachments had RPE detachments, 12 eyes (32.4%) had small RPE elevations or thickened RPE layer. RPE detachments in both SD-OCT and FFA in 3 eyes kept consistent. In 28 eyes, RPE lesions in SD-OCT were found in the same area of the fluorescein leakage spots in FFA. More RPE detachments and neuro-retina detachments were found in SD-OCT than in FFA. Conclusions Small RPE elevations, thickened RPE layer, or RPE detachments can be found in the retinal detachment areas by SD-OCT in most CSC patients. Low or disappeared signals may exist in the IS/OS junction. -
图 2 40岁女性患者中心性浆液性视网膜病变FFA图像
A.眼底彩色照相, 可见黄斑区浆液性神经上皮脱离; B.FFA早期, 可见两处点状高荧光和一处边界清楚的高荧光斑片; C.FFA中期, 一处点状高荧光渗漏明显; D.FFA晚期, 可见典型的蘑菇状高荧光, 其他两处病变荧光轻度减弱
FFA:同图 1图 3 28岁男性患者中心性浆液性视网膜病变FFA图像
A.眼底彩色照相, 可见黄斑区小片不规则黄色病变; B.FFA早期, 可见片状不规则高荧光; C.FFA中期, 片状高荧光轻度增强, 但范围不变; D.FFA晚期, 片状高荧光轻度减弱, 范围仍无变化
FFA:同图 1图 4 28岁男性患者中心性浆液性视网膜病变SD-OCT图像
A.SD-OCT可见黄斑区神经上皮脱离, 外界膜信号基本完整, IS/OS信号减弱变薄, 中心凹下色素上皮不规则及色素上皮隆起; B.相对应的眼底彩色照相可见色素上皮病变位置与FFA病变位置相一致
SD-OCT、IS/OS、FFA:同图 1 -
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