中心性浆液性脉络膜视网膜病变眼底近红外线成像特征  

Characteristics of near infrared imaging in central serous chorioretinopathy

作　　者：周小明[1] 郝保安[1] 彭锡嘉[1] 

机构地区：[1]甘肃省康复中心医院眼科,甘肃省兰州市730000

出　　处：《眼科新进展》2011年第10期976-979,共4页Recent Advances in Ophthalmology

摘　　要：目的分析中心性浆液性视网膜脉络膜病变(central serous chorioretinopathy,CSC)患者眼底近红外线(near infrared,NIR)成像的特点。方法对26例(28眼)CSC患者应用Kowa眼底照相机进行眼底照相、新型海德堡造影系统HRA2进行NIR成像、荧光素眼底血管造影、吲哚菁绿脉络膜血管造影检查,并对结果进行分析。结果眼底照相:20眼急性CSC表现为黄斑区神经上皮浆液性脱离,2眼伴视网膜色素上皮脱离(pigmented epithelial detachment,PED);8眼慢性迁延性CSC表现为黄斑区色素脱失。FFA检查显示:20眼急性CSC均有视网膜色素上皮(retinal pigment epithelium,RPE)渗漏;慢性迁延性CSC FFA早期表现为斑驳样透见荧光,晚期可见荧光素缓慢渗漏。ICGA检查:早期20眼可见区域性脉络膜血管充盈迟缓;ICGA中期可见脉络膜血管通透性增高,呈强荧光;18眼ICGA揭示的病灶要比FFA多。PED在FFA和ICGA均表现为边界清晰的盘状强荧光。NIR检查:神经上皮层脱离区表现为椭圆形暗区,边界清晰或模糊;PED在NIR表现为边界清晰的圆形暗区;RPE损害在NIR表现为灰白色区域。结论红外线成像技术为CSC的诊断提供了一个新的无创性的检查方法,但有关CSC NIR像的特征尚需进一步总结。Objective To investigate the characteristics of near infrared（NIR） imaging in central serous chorioretinopathy（CSC）.Methods About 28 eyes of 26 patients with CSC were examined with fundus photography by Kowa fundus camera,Heidelberg Retina Angiography 2（HRA2） with NIR imaging,fundus fluorescein angiography（FFA） and indocyanine green angiography（ICGA）.The results were anlayzed.Results Twenty eyes were with acute CSC showing serous macular neurosensory detachment and two eyes combined with pigmented epithelial detachment（PED） in fundus photography.Eight eyes were with chronic CSC showing macular depigmentation.Twenty eyes with acute CSC in FFA revealed RPE leakage.Eight eyes with chronic CSC wind defect in early phase of FFA and slight leakage in middle phase of FFA.In the early phase of ICGA,20 eyes showed showed regional choroidal delayed filling.In the middle and late phase of ICGA,20 eyes showed choroidal hyperfluorescence.About 18 eyes presented with more lesions in ICGA than in FFA.PED showed well defined hyperfluorescence both in FFA and ICGA.The detachment of the neuroretina could be visualized by NIR imaging oval-shaped structures with clear or less blur boundaries.PED in NIR showed a clear round dark area.RPE damage in NIR showed gray area.Conclusion NIR imaging provides a noninvasive,in vivo method to image changes in the RPE/Bruch membrane of CSC,but the specificity of the features needs to be investigated in further studies.

关 键 词：中心性浆液性视网膜脉络膜病变 荧光素眼底血管造影 吲哚菁绿脉络膜血管造影 近红外线成像 

分 类 号：R773.4[医药卫生—眼科] R774.1[医药卫生—临床医学]