摘要
目的应用共聚焦眼底血管造影联合光学相干断层成像技术(HRA+频域OCT系统)观察中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)荧光素渗漏点,评估渗漏点频域OCT图像特征。方法临床确诊为CSC患者18例(21眼)接受HRA+频域OCT检查,其中男13例(13眼),女5例(8眼);年龄31～71岁,平均44.9岁,分析33处荧光素渗漏点的同步眼底血管造影及频域OCT图像。结果应用HRA中荧光素血管造影同步定位急性CSC12眼的14处荧光素渗漏点,频域OCT显示13处荧光素渗漏点(92.9%)伴有微小色素上皮脱离(pigment epithelium detachment,PED)及视网膜色素上皮(reti-nal pigment epithelium,RPE)层光带异常改变,1处渗漏点可见较大PED(7.1%),其中3处渗漏点可见RPE光带断裂(21.4%)。在复发性CSC7处渗漏点中,频域OCT显示5处荧光素渗漏点显示PED(71.4%),较大的PED可以在其他2处荧光素渗漏点被观察到(28.6%);6处渗漏点可以看到RPE结节状突起(85.7%)。在慢性CSC6眼的12处荧光素渗漏点中,频域OCT显示7处渗漏点有微小PED,2处渗漏点可见中等程度的PED,而3处荧光素渗漏点可见高度隆起的PED(25.0%)。结论应用HRA+频域OCT系统可以对CSC的荧光素渗漏点进行准确定位,并对RPE层病理组织结构进行精确分析,大大提高了渗漏点处微小PED的检出率。研究发现微小PED、RPE形态学改变和RPE的断裂是CSC荧光素渗漏点中普遍存在的病理特征。
Objective To observe the fluorescein leakage spot,and estimate the image character of optical coherence tomography （OCT） in central serous chorioretinopathy （CSC） by confocal fundus fluorescein angiography and OCT （the spectralis HRA＋OCT-ophthalmoscope system）.Methods Twenty-one eyes of 18 patients （13 men 13 eyes,5 women 8 eyes;age range from 31 years old to 71 years old,mean 44.9 years old） diagnosed with CSC were examined with HRA-OCT-ophthalmoscope,the fundus fluorescein angiography and OCT images in 33 fluorescein leakage spots were analyzed.Results Of 14 fluorescein leakage spots in 12 eyes with acute CSC,OCT showed RPE abnormalities with minute pigment epithelial detachment （PED） in 13 fluorescein leakage spot （92.8%）,large PED in one spot （7.1%）,and the break of pigment epithelial with PED could be found in 3 fluorescein leakage spots（21.4%）.Of 7 fluorescein leakage spots in 3 eyes with recurrent CSC,OCT showed minute PED in 5 fluorescein leakage spots （71.4%）,large PED in 2 leakage spots （28.6%）.Irregular lesions in retinal pigment epithelium （RPE） and rough RPE layer could be found in 6 leakage spots （85.7%）.Of 12 fluorescein leakage spots in 6 eyes with chronic CSC,OCT showed minute PED in 7 fluorescein leakage spots（58.3%）,moderate PED could be found in 2 leakage spots（16.7%） and was consistent with the bulge of RPE in 3 fluorescein leakage spots （25.0%）.Conclusion The spectralis HRA＋OCT can detect the morphologic changes of RPE easily and noninvasively at the point of fluorescein leakage in eyes with CSC,which increase the detection rate of minute PED.Minute PED,morphologic changes of RPE and break of RPE are general pathologic characteristics of fluorescein leakage in CSC.
出处
《眼科新进展》
CAS
北大核心
2010年第7期679-682,685,共5页
Recent Advances in Ophthalmology
