光相干断层扫描检查在中心性浆液性脉络膜视网膜病变中的应用  

Clinical application of optical coherence tomography in central serous chorioretinopathy

作　　者：何晓健[1] 徐永宁[1] 张惠成[1] 项燕[1] 陈滨[1] 

机构地区：[1]杭州市第一人民医院眼科,310006

出　　处：《浙江医学》2010年第6期810-812,共3页Zhejiang Medical Journal

摘　　要：目的探讨光相干断层扫描（OCT）在检测中心性浆液性脉络膜视网膜病变（CSC）中的应用价值。方法对60例（60眼）经眼底荧光血管造影（FFA）诊断为单眼初发的CSC患者进行时域OCT检查，观察其形态学特征，并对病变图像进行定量测量和分析。其中34例（34眼）在恢复期行OCT复查，对比分析发作期与恢复期视力及黄斑中心凹视网膜厚度的定量测量结果。采用直线相关法对视网膜浆液性脱离区各参数与视力进行相关性分析。结果（1）FFA检查结果：单纯视网膜神经上皮脱离51眼（2眼经OCT检查证实为视网膜神经上皮合并色素上皮脱离），单纯视网膜色素上皮脱离4眼，视网膜神经上皮合并色素上皮脱离3眼．其他2眼（经OCT检查证实为单纯视网膜色素上皮脱离）。（2）OCT检查结果：单纯视网膜神经上皮脱离49眼，单纯视网膜色素上皮脱离6眼，神经上皮合并色素上皮脱离5眼。（3）恢复期患者视力较发作期患者有所提高，但并无统计学意义（P〉0.05）；而恢复期黄斑中心凹视网膜厚度显著薄于发作期（P〈0．01）。（4）视力与神经上皮浆液性脱离水平横径、垂直纵径、高度及中心凹6mm范围内容积均显著相关fP〈0．01），与黄斑中心凹视网膜厚度、色素上皮脱离范围无明显相关性（P〉0.05）。结论OCT能够无创伤性地在活体上观察CSC视网膜组织形态学改变，可明确应用于CSC的临床分型及视力的预后评估。Objective To evaluate the clinical application of optical coherence tomography （OCT） in central serous chorioretinopathy （CSC）. Methods Sixty consecutive cases （60 eyes） with the diagnosis of unilateral initial CSC by FFA were examined with time-domain OCT. The morphological changes were observed. The pathological changes were measured and analyzed. The difference of retinal thickness at the fovea on the acute phase and recovery phase was evaluated in 34 cases （34 eyes）. The relationship between the visual acuity and the parameter of the retinal detachment was analyzed by linear regression. Results FFA showed that there were 51 eyes with neurosensory serous detachment （combination with pigment epithelial detachment was confirmed by OCT in 2） , 4 with pigment epithelial serous detachment, 3 with neurosensory and pigment epithelial serous detachment, and 2 with other conditions （confirmed as pigment epithelial detachment by OCT）. OCT showed there were 49 eyes with neurosensory serous detachment, 6 with pigment epithelial serous detachment, and 5 with neurosensory complicated with pigment epithelial serous detachment. Compared to the acute phase, the visual acuity was improved in the resolved phase, but the improvement was not statistically significant （P〉 0.05）. The retinal thickness at the fovea in the resolved phase was significantly thinner than that in the acute phase （ P〈0.01 ）. The visual acuity was correlated with horizontal diameter, vertical diameter, height and the total fovea volume within 6 mm range （P〈 0.01 ）. There was no correlation of visual acuity with the retinal thickness at the fovea and the range of pigment epithelial serous detachment （P〉0.05）. Conclusion OCT examination shows morphologic changes of the retina noninvasively and can be used for clinical classification and visual prognosis in patients with CSC.

关 键 词：脉络膜视网膜炎 诊断 荧光血管造影术 体层摄影术 光学相干 

分 类 号：R774.1[医药卫生—眼科]