急慢性中心性浆液性脉络膜视网膜病变的自身荧光和频域光相干断层扫描图像特征  

Characteristics of spectral-domain optical coherence tomography and fundus autofluorescence in acute and chronic central serous chorioretinopathy

作　　者：林冰[1] 孙祖华[1] 李岩[1] 周容[1] 郑微微[1] 周挺业[1] 刘晓玲[1] 

机构地区：[1]温州医学院附属眼视光医院眼底内科, 325027

出　　处：《中华眼底病杂志》2012年第4期321-324,共4页Chinese Journal of Ocular Fundus Diseases

基　　金：温州市科技计划资助项目（Y20100293）;温州市科技局资助项目（Y20110092）

摘　　要：目的 观察急慢性中心性浆液性脉络膜视网膜病变（CSC）的自身荧光（AF）和频域光相干断层扫描（OCT）图像特征。方法 经裂隙灯显微镜、彩色眼底照相、荧光素眼底血管造影（FFA）、吲哚青绿血管造影检查确诊为CSC的67例患者73只眼纳入研究。所有患者同时行AF及频域OCT检查。根据患者临床及FFA表现，将其分为急性、慢性CSC 2种类型，分别为37例37只眼、30例36只眼。根据黄斑区神经上皮脱离区的AF表现将其分为单纯减弱型、单纯增强型及混合改变型3种类型。根据频域OCT检查显示的神经上皮脱离区内外节的表现将其分为外节保存完整型、外节保存不全型及外节萎缩型3种类型。观察急慢性CSC患者的AF及OCT图像特征。结果 AF检查发现，急性CSC 37只眼中，单纯减弱型AF 19只眼，占51.35%；单纯增强型AF 18只眼，占48.65%。慢性CSC 36只眼中，单纯减弱型AF 2只眼，占5.56%；单纯增强型AF 16只眼，占44.44%；混合改变型AF 18只眼，占50.00%。急慢性CSC患者3种AF表现的眼数比较，差异有统计学意义（χ2=31.872，P=0.000）。频域OCT检查发现，急性CSC 37只眼中，外节保存完整型15只眼，占40.54%；外节保存不全型18只眼，占48.65%；外节萎缩型4只眼，占10.81%。慢性CSC 36只眼中，外节保存完整型5只眼，占13.89%；外节保存不全型17只眼，占47.22%；外节萎缩型14只眼，占38.89%。急慢性CSC患者3种OCT表现的眼数比较，差异有统计学意义（χ2=10.572，P=0.005）。结论 急性CSC的AF表现以单纯减弱型为主，慢性CSC的AF表现以混合改变型为主。急性CSC的OCT表现以外节保存不全型和外节保存完整型为主，慢性CSC的OCT表现以外节保存不全型和外节萎缩型为主。Objective To observe the characteristics of spectraldomain optical coherence tomography （SD-OCT） and fundus autofluorescence （FAF） in acute and chronic central serous chorioretinopathy （CSC）.Methods Seven-three eyes of 67 patients with CSC diagnosed by slit-lamp microscopy, fundus photochromy, fundus fluorescein angiography （FFA） and indocyanine green angiography were enrolled in this study. All the patients were examined for FAF and SD-OCT. The patients were divided into acute CSC group （37 patients, 37 eyes） and chronic CSC group （30 patients,36 eyes） according to the clinical features and FFA images. According to the OCT feature in retinal detachment area, they were divided into three categories, which including intact, non-intact and atrophy outer segment, respectively. According to the FAF characteristics, they were divided into hyper-FAF, hypo-FAF and mixed type, respectively. The characteristics of SD-OCT and FAF of both acute and chronic CSC patients were evaluated and analyzed. Results In acute CSC group, 19 eyes （51.35%） were hypo-FAF, 18 eyes （48.65%） were hyper-FAF. In chronic CSC group, two eyes （5.56%） were hypo-FAF, 16 eyes （44.44%） were hyper-FAF, and 18 eyes （50.00%） were mixed type. There was significant difference between both groups （χ2=31.872,P=0.000）. The SD-OCT results showed that in acute group, 15 eyes （40.54%） were intact outer segment, 18 eyes （48.65%） were non-intact outer segment, and four eyes （10.81%） were atrophy outer segment. In chronic group, five eyes （13.89%） were intact outer segment, 17 eyes （47.22%） were non-intact outer segment, and 14 eyes （38.89%） were atrophy outer segment. There was significant difference between both groups （χ2=10.572,P=0.005）. Conclusions The FAF characteristics of acute and chronic CSC mainly manifests hypo-FAF and mixed type, respectively. The OCT characteristics of acute CSC mainly manifests intact outer segment and non-intact outer segment, but non-intact outer segme

关 键 词：视网膜疾病/诊断 脉络膜疾病/诊断 色素上皮 眼 体层摄影术 光学相干 诊断显像 

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