中心性浆液性脉络膜视网膜病变治疗前后视网膜色素上皮-Bruch膜-脉络膜毛细血管复合体中Bruch膜的光相干断层扫描分型特征  

Classification of Bruch＇ s membrane in the choriocapillario-Bruch＇ s membrane-retinal pigment epithelium complex in central serous chorioretinopathy by optical coherence tomography

作　　者：周容[1] 贾晓林[1] 孙祖华[1] 林冰[1] 高伟娜[1] 郑微微[1] 李英姿[1] 刘晓玲[1] 

机构地区：[1]温州医学院附属眼视光医院,325027

出　　处：《中华眼底病杂志》2011年第4期323-326,共4页Chinese Journal of Ocular Fundus Diseases

基　　金：国家自然科学基金（30470563）

摘　　要：目的观察中心性浆液性脉络膜视网膜病变（CSC）治疗前后视网膜色素上皮-Bruch膜-脉络膜毛细血管复合体（CBRP—C）中Bruch膜（BM）在光相干断层扫描（OCT）中的分型特征。方法回顾性病例对照研究。临床确诊为CSC并经激光光凝或半剂量光动力疗法（PDT）治疗的60例患者60只眼纳入本研究。其中，激光光凝治疗51只眼，半剂量PDT治疗9只眼。治疗前后所有患者均采用频域OCT扫描黄斑区，以BM为核心观察指标对CBRP—C行整体观察。根据BM反射带是否显现，将其分为不可辨型BM和可辨型BM。再根据视网膜色素上皮（RPE）下有无液腔，将可辨型BM分为显型BM和隐型BM。对比分析患者治疗前后CBRP—C中BM分型的变化情况。结果治疗前，60只眼均为可辨型BM。其中，显型BM59只眼，占98．3％；隐型BM1只眼，占1．7％。治疗后1个月，激光治疗组51只眼中，可辨型BM50只眼，占98．0％；不可辨型BM1只眼，占2．0％。可辨型BM50只眼中，显型BM34只眼，占68．0％；隐型BM16只眼，占32．0％。PDT治疗组9只眼中，可辨型BM8只眼，占88．9％；不可辨型BM1只眼，占11．1％。可辨型BM8只眼中，显型BM1只眼，占12．5％；隐型BM7只眼，占87．5％。结论CSC患眼治疗前后CBRP—C中BM在OCT中均存在显型BM，但治疗后较治疗前有所好转。Objective To observe the types and features of Bruch＇ s membrane （BM） in the choriocapillario-Bruch＇s membrane-retinal pigment epithelium complex （CBRP-C） in central serous chorioretinopathy （CSC） by optical coherence tomography （OCT）. Methods This is a retrospective case control study. Sixty eyes of 60 patients （43 males, 17 females） with CSC who underwent laser photocoagulation （51 eyes） or half-dose verteporfin photodynamic therapy （9 eyes） were enrolled. The macular area of all the patients was scanned by Spectralis-OCT before and after the treatment, BM was observed as the core indicators of CBRP-C. According to the reflection band, BM was classified into distinguishable BM and indistinguishable BM. The distinguishable BM was classified into phenotype BM （with a sub-RPE fluid cavity） and cryptotype BM （without a sub-RPE fluid cavity）. The types and features of BM in CBRP-C of CSC patients before and after the treatment were comparatively analyzed. Results Before the treatment, distinguishable BM were observed in all patients, including 59 eyes （98.3%） with phenotype BM and 1 eye （1.7%） with cryptotype BM. At 1 month after laser photocoagulation, there were, 1/51 eye （2.0%） with indistinguishable BM, and 50/51 eyes （98.0%） with distinguishable BM, including 34 eyes （68.0%） with phenotype BM and 16 eyes （32.0%） with cryptotype BM. At 1 month after half-dose PDT, there were 1/9 eye （11.1%） with indistinguishable BM and 8/9 eyes （88.9%） with distinguishable BM, including 1 eye （12.5%） with phenotype BM and 7 eyes （87.5%） with cryptotype BM. Conclusion The phenotype BM exists in CSC patients before and after the treatment, but it has been improved after treatment.

关 键 词：视网膜疾病/治疗 脉络膜疾病/治疗 色素上皮 眼 BRUCH膜 体层摄影术 光学相干 

分 类 号：R774.1[医药卫生—眼科] R770.43[医药卫生—临床医学]