中心性浆液性脉络膜视网膜病变光学相干断层扫描与中心视野观察  

Clinical observation of optical coherence tomography and visual field in central serous chorioretinopathy

作　　者：杨凯转[1] 杨丽亚[1] 徐延山[1] 

机构地区：[1]天津医科大学眼科临床学院天津市眼科医院,300020

出　　处：《中国实用眼科杂志》2014年第1期49-52,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察中心性浆液性脉络膜视网膜病变（central serous chorioretinopathv，CSC）的光学相干断层扫描（optical coherence tomography，OCT）和视野参数的特征及相关性。方法临床病例系列研究。对2012年8～12月在天津市眼科医院就诊的急性期CSC患者30例（30只眼），并将其对侧眼作为正常对照组，进行OCT定量测量黄斑区视网膜厚度，Humphrey-750i型自动视野计分析黄斑10。的平均光敏感度（meansensitivity，MS）、平均偏差（meandeviation，MD）和黄斑中心凹光敏感度（Foveal sensitivity）。采用统计学软件分析数据，评价急性期CSC患者黄斑区形态与功能的相关性。结果CSC患眼的直径1mm的中央区视网膜厚度、3mm旁中心凹视网膜平均厚度和直径5mm的中心凹周围平均视网膜厚度与对侧眼比较，差异均有统计学意义（P〈0．05），CSC患眼的MS、MD和Fovealsensitivity与对侧眼比较，差异均有统计学意义（P〈0．05），患眼组的直径1mm的中央区视网膜厚度与黄斑中心凹光敏感度差异有统计学意义（r=-0．546，P=0．002）；3mm旁中心凹视网膜平均厚度与MS差异有统计学意义（r=-0．631，P=0．000），与MD比较差异有统计学意义（r=-0．493，P=0．007，P〈0．05）。结论急性期CSC患者的OCT横断面图像可以清楚显示眼底后极部黄斑区或附近视网膜神经上皮层局限性浆液性脱离，伴或不伴有视网膜色素上皮的脱离；视野检查常见中心暗点，呈圆形或椭圆形。OCT与视野相结合能更全面评估中心性浆液性脉络膜视网膜病变微结构及与结构变化相应的功能改变，更好地了解CSC急性期形态与视觉功能的变化。Objective To evaluate the characteristics of and the association between the optical coherence tomography （OCT） results and visual field index for acute central serous chorioretinopathy （CSC）. Methods Thirty patients （30 eyes） suffering acute CSC were selected randomly and fellow eyes were as normal control group. Optical coherence tomography （OCT） examination and visual field test were applied to each group： OCT for retinal macular thickness and Humphrey-750i automated perimeter for the mean sensitivity （MS）, mean deviation （MD） as well as foveal sensitivity of macular （10°）. The relationship between the results of macular morphology and function were analyzed by SPSS. Results The OCT scan showed that the comparison of the average retinal thickness in the central lmm diameter area, the average thickness of macula central fovea for 3ram paracentral and the average retinal thickness in the macula central fovea of 5ram pericentral between affected and fellow eyes had statistical significance （P 〈0.05）. The visual field test showed that the comparison of the MS, MD and foveal sensitivity between affected and fellow eyes had statistical significance （P 〈0.05）. The average retinal thickness in the central lmm diameter area affected eyes was associated with the negativeness of central light sensitivity （r =-0.546, P =0.002）, and the average thickness of macula central fovea for 3mm paracentral was associated with the negativeness of MS （r =-0.631, P =0.000）, also associated with the negativeness of MD （r =-0.493, P =0.007）. In cross-sectional images of OCT, it can be clearly demonstrated that the morphological changes of the localized serous neuroepithelial detachment with or without the pigment epithelium detachment at macular area; visual field provides round or oval central scotoma for macular （10°） of CSC patients. Conclusions The association of OCT and visual field develops a more comprehensive evaluation for the transitions of relevant functions in stru

关 键 词：中心性浆液性脉络膜视网膜病变 光学相干断层扫描 视野 

分 类 号：R774.1[医药卫生—眼科]