摘要
目的 :探讨中心性浆液性脉络膜视网膜病变 (中浆 )患者视网膜与脉络膜循环的改变 ,旨在提供病因依据 ,以指导临床治疗。方法 :随机选取我院门诊已确诊为中浆的患者 16例 ( 2 1只眼 ) ,经双眼散瞳后分别行眼底荧光血管造影 (fundusfluoresceinan giography ,FFA)和吲哚青绿血管造影 (indocyaninegreenangiography ,ICGA) ,对比分析其改变。结果 :1 FFA检查 :所有患者均显示明显的晚期渗漏 ;4只眼 ( 19% )合并视网膜色素上皮脱离 (pigmentepithelialdetachment ,PEDS)。 2 ICGA检查 :( 1) 2例脉络膜动脉充盈缺损 ,余 14例早期呈动脉充盈迟缓。 ( 2 )与FFA中渗漏对应的脉络膜高渗透性 ,范围大于FFA中所见。统计学分析具有明显差异 (P <0 0 0 1)。 ( 3 )FFA未发现异常的区域 ,ICGA可见局灶或多灶性脉络膜的高渗透区。 ( 4 )与FFA中对应的PEDS及多个隐匿性的PEDS ;PEDS在ICGA中具有典型特征。结论 :脉络膜循环障碍及渗透性增强是中浆最基本的病理改变。比较FFA与ICGA检查结果 ,我们认为中浆病人脉络膜循环障碍比视网膜循环障碍更为严重。
Objective:To evaluate the changes in the retinal circulation and choroidal circulation in cases of central serous chorioretinopathy(CSCR). Methods:On 21 eyes of 16 patents with CSCR diagnosed clinically,complete clinical ophthalmologic examinations,fundus fluorescein angiography(FFA)and indocyanine green angiography(ICGA)with digital imaging analysis system were performed under under dilated pupils.The images obtained were analyzed and compared. Results:FFA leakages were observed in all of 21 eyes(100%)and pigment epithelial detachments(PEDS)in 4 of 21 eyes(19%).In ICGA,14 patients with acute and chronic recurrent CSCR demonstrated a localized delay in arterial filling followed by choroidal hyperfusion in the area of the damaged retinal pigment epithelium(RPE)and leakages in the midphase of the anagiography;2 of 16 patients showed remaining hypofluorescent around the site of focal leakage through the phase of angiography because of ischemia.Mutiple and mutifocal areas of choroidal hyperfluorescence were observed throughout the fundus of diseased eyes and 'normal'fellow eyes.A detachment of the RPE was detected in 79% of patients. Conclusions:Choroidal circulation disturbance and choroidal hypermeability may be a causative factor of CSCR,and choroidal circulation defects were more serious than that in retinal circulation.
出处
《中国实用眼科杂志》
CSCD
北大核心
2003年第9期676-679,共4页
Chinese Journal of Practical Ophthalmology
