引起黄斑下脉络膜新生血管的几种常见疾病的光相干断层扫描图像特征分析  

Characteristics of optical coherence tomography for several common diseases which could lead to submacular choroidal neovascularization

作　　者：王凯[1] 姜燕荣[1] 黎晓新[1] 殷春悦[1] 徐秀兰[1] 

机构地区：[1]北京大学人民医院眼科,100044

出　　处：《中华眼底病杂志》2005年第2期69-73,共5页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的　观察引起黄斑下脉络膜新生血管 (CNV)的几种常见疾病的光相干断层扫描 (OCT)图像特征并对其分类 ,为 CNV的鉴别诊断和治疗提供依据。　方法　回顾分析经常规眼底检查以及荧光素眼底血管造影 (FFA)检查确诊的老年性黄斑变性 (AMD)、病理性近视、中心性渗出性脉络膜视网膜炎(CEC)和特发性脉络膜新生血管 (ICNV)患者 16 5例 187只眼的 OCT检查资料 ,结合 FFA检查结果对OCT图像进行分类并总结分析各类图像特征。　结果　可确定边界的 CNV6 0只眼 ,表现为边界清楚的视网膜色素上皮 (RPE)层和脉络膜毛细血管层的梭形增厚 ;不易确定边界的 CNV10 1只眼 ,表现为弥散的脉络膜反向散射增强 ;浆液性 RPE脱离 19只眼 ,表现为 RPE下的光学暗区 ;出血性 RPE脱离 11只眼 ,表现为 RPE下的高反向散射区域 ,迅速衰减 ;纤维血管性 RPE脱离 10只眼 ,表现为 RPE和脉络膜之间的轻至中度无反向散射区 ;神经上皮脱离 4 5只眼 ,表现为神经上皮层与 RPE分离 ,其间为光学暗区。　结论　引起黄斑下 CNV的几种常见疾病的 OCT图像可以分为 6类 ,分析 OCT的图像特征有助于 CNV的鉴别诊断与治疗。Objective To observe and classify the characteristics of optical coherence tomography (OCT) for several common diseases which could lead to submacular choroidal neovascularization (CNV), and to provide the warrant to make the differential diagnosis and treatment of CNV. Methods The data of OCT of 165 patients (187 eyes) with CNV due to AMD, CEC, high myopia and ICNV diagnosed by fundus photography and fundus fluorescein angiography (FFA) were retrospectively analyzed, and the images of OCT were classified considering the results of FFA, and the characteristics of different types of the images were sumerized. Results Well-defined fusiform thickening of retinal pigment epithelial (RPE) and choriocapillary layer in CNV with well-defined border (60 eyes), dispersed backscattering increase in poorly-defined CNV (101 eyes), optic darkspace beneath RPE layer in serous detachment of RPE layer (19 eyes), quickly decreased high backscattering region under RPE layer in hemorrhagic detachment of RPE layer (11 eyes), slight to moderate backscattering region between RPE layer in fibrovascular detachment of RPE layer (10 eyes), and detachment of neurepithelial layer from RPE layer with the optic darkspace between the layers in detachment of neurepithelial layer (45 eyes) were observed. Conclusions The images of OCT for the common diseases which could lead to submacular choroidal neovascularization may be divided into 6 types. Analyzing the characteristics of images of OCT is helpful in differential diagnosis and treatment of CNV.

关 键 词：RPE CNV 脉络膜新生血管 光相干断层扫描 治疗 黄斑 OCT 目的观 光学 结论 

分 类 号：R773.4[医药卫生—眼科]