FFA和OCT在Vogt-小柳原田病和多发中心性浆液性脉络膜视网膜病变鉴别诊断中的影像学特点  

Distinguishing Vogt-Koyanagi-Harada disease from multiple central serous chorioretinopathy with OCT and FFA

作　　者：傅敏[1] 杨庆松[1] 汪峻岭[1] Min Fu Qing-Song Yang Jun-Ling Wang(Department of Ophthalmology, Nanjing Tongren Hospital Affiliated to Southeast University, Nanjing 211102, Jiangsu Province, China)

机构地区：[1]东南大学附属医学院南京同仁医院眼科,中国江苏省南京市211102

出　　处：《国际眼科杂志》2017年第9期1777-1779,共3页International Eye Science

摘　　要：目的:探讨荧光素钠眼底血管造影(fundus fluorescein angiography,FFA)与频域光学相干断层扫描(optical coherence tomography,OCT)检查在Vogt-小柳原田病(Vogt-Koyanagi-Harada disease,VKH)和多发中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)鉴别诊断中的影像学特点。方法:回顾性分析2009/2016来我院接受诊治的VKH患者17例32眼和多发CSC患者30例35眼,通过FFA和OCT检查对比分析两种疾病的影像学特征。结果:VKH患者早期多呈密集针尖样高荧光,晚期多湖状荧光积存17眼(53%),视盘相对高荧光24眼(75%)。多发CSC患者早期多处点状高荧光,随时间延长渗漏,晚期有2眼(6%)视盘相对高荧光。VKH患者14例28眼于我院行OCT检查,多发CSC患者22例25眼于我院行OCT检查,其中RPE皱褶仅见于VKH患者,而内界膜波浪样改变和膜样结构较多见于VKH患者,对鉴别多发CSC敏感度(54%、68%)较高。结论:VKH和多发CSC在FFA、OCT检查方面有一定相似性,但FFA和OCT检查可显示不同的影像学特点,对VKH、多发CSC的诊断各具优势,两者结合最有利于VKH和多发CSC的鉴别诊断。AIM： To observe the image features of Vogt-Koyanagi- Harada disease （VKH） and multiple central serous chorioretinopathy （ CSC ） by fundus fluorescein angiography （FFA） and optical coherence tomography （OCT）. METHODS： Thirty-two eyes of 17 patients with VKH and thirty-five eyes of 30 patients with multiple CSC were collected from 2009 to 2016 in my hospital. RESULTS： All the eyes with VKH were found small and dense fluorescein leakage in the early stage. The 17 eyes （53%） with VKH were found fluorescein accumulation in the final stage; 24 eyes （75%） with VKH were found high fluorescence of optic disc. All of eyes with multiple CSC were found multifocal leakage in the early stage. And 2 eyes （6%） with multiple CSC were found high fluorescence of optic disc. There were 28 eyes （14 patients） with VKH and 25 eyes （22 patients） with multiple CSC had been done OCT in my hospital. Retinal pigment epithelial fold was only found in VKH. Fluctuation of internal limiting membrane （ILM） and membrane structure had higher sensitivity to diagnostic VKH from to multiple CSC, with sensitivity of 54% and 68% respectively. CONCLUSION： There are some similarities as well as differences between FFA and OCT in diagnosis of VKH and multiple CSC. A combination usage of FFA and OCT can be more effective in distinguishing VKH frommultiple CSC.

关 键 词：VOGT-小柳原田病 多发中心性浆液性脉络膜视网膜病变 荧光素眼底血管造影 频域光学相干断层扫描 鉴别诊断 

分 类 号：R773.9[医药卫生—眼科] R774.1[医药卫生—临床医学]