脉络膜皱褶的临床特征分析  

Analysis on clinical characteristics of choroidal folds

作　　者：陈长征[1] 周芸芸[1] 余运娴[1] 郑红梅[1] 陈静[1] 邢怡桥[1] 

机构地区：[1]武汉大学人民医院眼科,430060

出　　处：《中华眼底病杂志》2008年第5期352-354,共3页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察脉络膜皱褶患者眼底、荧光素眼底血管造影（FFA）、吲哚青绿血管造影（ICGA）和光相干断层扫描（OCT）等临床特征。方法回顾性分析34例脉络膜皱褶患者62只眼的临床资料。其中伏格特小柳原田综合征10例20只眼，Behcet病1例2只眼，其他类型葡萄膜炎11例21眼，视盘水肿5例9只眼，脉络膜肿瘤2例2只眼。低眼压性黄斑病变2例4只眼，Graves眼病1例2只眼，眼钝挫伤1例1只眼，脉络膜渗漏综合征1例1只眼。所有患者均行直接检眼镜、眼底彩色照相、FFA检查，9例17只眼同时行ICGA检查，9例18只眼同时行OCT检查。结果脉络膜皱褶眼底表现为明暗相间的条纹，其数量多少不限，在后极部呈放射状、水平状、斜行或以黄斑为中心同心圆样排列，也可表现为围绕视盘呈放射样排列，但很少超过赤道部。FFA观察到的皱褶数量比眼底表现多，主要是细小皱纹和粗大皱褶。条状弱荧光在动静期明显，晚期无荧光渗漏。ICGA检查显示，早期表现为条状弱荧光或正常荧光，晚期为强荧光或弱荧光，与FFA的弱荧光条带相对应，但没有FFA表现明显。OCT检查显示皱褶累及脉络膜和视网膜色素上皮层。结论脉络膜皱褶为累及脉络膜和视网膜色素上皮层的明暗相间的眼底条纹，造影表现为无荧光素渗漏的条状弱荧光。熟悉脉络膜皱褶的影像学特征有助于临床上发现脉络膜皱褶及原发疾病。Objective To investigate the imaging characteristics of patients with choroidal folds, which including ocular fundus, fundus fluorescein angiography （FFA）, indocyanine green angiography （ICGA） and optical coherence tomography （OCT）. Methods The clinical data of 62 eyes of 34 patients with choroidal folds were analyzed retrospectively. The patients include 10 patients （20 eyes） of Vogt- Koyanagi-Harada syndrome, 1 patients（2 eyes） of Behcet diseases, 11 patients（21 eyes） of other uveitis, 5 patients （9 eyes） of papolloedema, 2 patients （2 eyes） of choroidal tumor, 2 patients （4 eyes） of, hypotony with macular degeneration, 1 patient（2 eyes） of,Graves diseases, 1 patient （1 eye） of,blunt trauma and 1 patient （1 eye ） of uveal effusion syndrome. All patients underwent the examination of direct ophthalmoscope, fundus color photography and FFA, meanwhile, 9 patients （17 eyes） with ICGA examination, 9 patients（18 eyes） with OCT examination. Results Choroidal folds were bright and dark stripes on the fundus, their numbers were variable. They can be arranged radially, horizontally, oblique or concentrically around the macular area, or radiating from optic disk but rarely over equator region. On FFA there were more folds which were subjected to coarse folds and wrinkles. They were obvious at early stage and no leakage at late stage. On ICGA choroidal folds showed normal or hypofluoreseenee at early stage, and hyperfluorescence or hypofluorescenee at late stage. The hyperfluorescence or hypofluorescence bands were corresponding to the hypofluorescence of FFA but not obvious as FFA. On OCT ehoroidal folds involved choriod and retinal pigment epithelial layer （RPEL）. Conclusion Choroidal fold is a bright and dark stripes that involved choriod and RPEL. The angiography showed hypofluorescence bands without leakage. Be familiar with the imaging features of choroidal folds can help to found the choroidal folds and the original diseases.

关 键 词：脉络膜疾病/病因学 脉络膜疾病/诊断 荧光素血管造影术 吲哚花青绿/诊断应 用 体层摄影术 光学相干 脉络膜皱褶 

分 类 号：R773.9[医药卫生—眼科]