OCT血管成像术在中心性渗出性脉络膜视网膜病变中的应用  

Application of OCT angiography in central exudative chorioretinopathy

作　　者：黄超[1] 赵永[1] 王梅 喻亚梅 Huang Chao;Zhao Yong;Wang Mei;Yu Yamei(Department of Ophthalmology,Suzhou City Hospital,Anhui Province 234000,China)

机构地区：[1]安徽省宿州市立医院眼科,234000

出　　处：《临床眼科杂志》2019年第2期118-121,共4页Journal of Clinical Ophthalmology

摘　　要：目的观察相干光断层血管成像(OCTA)在中心性渗出性脉络膜视网膜病变(CEC)中的不同时期的影像特征,评价其在诊断中的作用。方法回顾分析2017年1月至2018年6月在我院就诊的21例(21只眼)经眼底检查、荧光素眼底血管造影(FFA)及相干光断层扫描(OCT)确诊为CEC患者的治疗前、治疗后1、2、3、4个月的临床资料,包括患者视力、屈光检查、眼底彩色图像、OCT及OCTA资料。患者均采用玻璃体腔注射雷珠单克隆抗体进行治疗。结果本研究患者均随访6个月以上。OCTA图像可现实脉络膜和视网膜毛细血管层血管的病变情况,并能够检查出脉络膜新生血管,并可发现视网膜色素上皮(RPE)损伤。14例CEC患者OCTA图像显示新生血管位于RPE下; 5例像显示新生血管位于RPE上; 2例显示视网膜黄斑部RPE层上下均可见新生血管。患者治疗前BCVA为0. 38±0. 42,治疗后1个月BCVA平均提高到0. 67±0. 36,治疗后2个月0. 73±0. 46,治疗后3个月0. 76±0. 32,治疗后4个月0. 78±0. 41,术后较术前显著提高。治疗前、后中央视网膜厚度(CFT)差异有显著性,术前、术后各随访时间点CFT的平均值分别是(456±94)μm、(240±83)μm、(218±78)μm、(181±83)μm和(173±75)μm。治疗前OCTA显示:视网膜出现深层和脉络膜新生血管(CNV)的有21例,治疗3个月时14例(66. 7%)CNV完全闭合; 4例(19. 0%) CNV部分闭合; 3例(14. 3%) CNV未闭合;有6例(28. 6%)出现RPE损害。结论OCTA能准确的发现CEC患者脉络膜和视网膜毛细血管层血管的病变及新生血管,指导临床治疗。Objective To observe the imaging features of OCTA in different stages of central exudative chorioretinopathy(CEC)and evaluate its role in diagnosis of CEC.Methods The study included 21 patients with CEC diagnosed by fundus examination,fluorescein fundus angiography(FFA)and optical coherence tomography(OCT)from January 2017 to June 2018.The clinical data was retrospectively analyzed,including visual acuity,refractive examination,fundus color image coherence tomography(OCT)and OCT angiography(OCTA).All patients were treated with intravitreal injection of Lucentis.Results All patients were followed up for more than 6 months.OCTA images can show the choroidal and retinal capillary vessels,choroidal neovascularization,and retinal pigment epithelium damage.The OCTA images of 14 CEC patients showed that the neovascularization was located under RPE,5 CEC patients showed that the neovascularization was located above RPE,and 2 CEC patients showed that the neovascularization was located above and under the RPE layer.BCVA of patients was 0.38±0.42 before treatment,BCVA increased to 0.67±0.36 on average in 1 month,0.73±0.46 in 2 months,0.76±0.32 in 3 months,0.78±0.41 in 4 months after treatment.BCVA was significantly higher after treatment.There was significant difference in central retinal thickness(CFT)between before and after treatment.The mean values of CFT were 456±94,240±83,218±78,181±83 and 173±75μm at preoperative and postoperative follow-up time points,respectively.OCTA showed that 21 cases had deep retinal and choroidal neovascularization before treatment.14(66.7%)eyes had CNV completely closed,4(19.0%)eyes had CNV partially closed,3(14.3%)eyes had CNV unclosed,and 6(28.6%)eyes had RPE damage at 3 months after treatment.Conclusions OCTA can accurately detect the choroidal and retinal microvascular lesions and neovascularization in patients with CEC,and guide clinical treatment.OCTA is noninvasive and convenient.It has advantages in diagnosis and follow-up of CEC.

关 键 词：相干光断层血管成像 中心性渗出性脉络膜视网膜病变 

分 类 号：R774.1[医药卫生—眼科]