慢性中心性浆液性脉络膜视网膜病变的多模式影像研究进展  

Research progress of multimodal imaging in chronic central serous chorioretinopathy

作　　者：阿卜杜拉·萨伍提(综述) 苏钰[1] 陈长征(审校)[1] Abdulla SAWUT;SU Yu;CHEN Changzheng(Department of Ophthalmology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院眼科中心,武汉430060

出　　处：《眼科学报》2025年第3期261-271,共11页Eye Science

摘　　要：慢性中心性浆液性脉络膜视网膜病变(chronic central serous chorioretinopathy,cCSC)以广泛的脉络膜视网膜异常为特征,包括脉络膜血管扩张及其引发的弥漫性视网膜色素上皮病变和浆液性视网膜脱离,常累及黄斑区,引起视功能损害。传统观点认为其可能由急性CSC演变而来,但近期研究显示两者在临床上存在明显差异。其病情反复、迁延,预后较差。随着光学相干断层扫描血管造影(optical coherence tomography angiography,OCTA)、超广角成像和en face重建成像等新多模式影像(multimodal imaging,MMI)技术的出现和人工智能及机器学习的发展,更多有意义的c CSC影像学特征不断出现。文章详细介绍了cCSC在眼底成像、眼底自发荧光(fundus autofluorescence,FAF)、光学相干断层扫描(optical coherence tomography,OCT)、眼底荧光素血管造影(fluorescein angiography,FFA)、吲哚菁绿血管造影和OCTA等影像技术中的表现,并探讨了人工智能在识别CSC分类及其OCT生物标志物等方面的应用。不同影像技术在cCSC的诊断和研究中各有优势,如FAF可能是评估疾病进展及变化的有效手段,OCT可更直观地观察视网膜结构的改变,FFA是识别渗漏点的重要检查手段,而OCTA可能是评估脉络膜微循环的的最佳手段等。这些MMI研究进展为深入了解cCSC的病理生理机制及临床特征提供了重要线索,有助于提高诊断的准确性和效率,改善患者的预后和生活质量。Chronic central serous chorioretinopathy(cCSC)is characterized by extensive retinochoroidal abnormalities.This includes diffuse retinal pigment epitheliopathy and serous retinal detachment associated with choroidal vasodilatation,often involving the macula and cause visual impairment.It was originally considered that it might evolve from acute CSC,but recent studies have shown significant clinical differences between the two.It tends to recur,be prolonged,and have an unfavorable prognosis.With the advent of new multimodal imaging(MMI)techniques such as optical coherence tomography angiography(OCTA),ultra-wide-field imaging,and en face reconstruction imaging,along with the advancement of artificial intelligence and machine learning,more significant cCSC imaging characteristics have been constantly emerging.This article provides a comprehensive overview of cCSC’s imaging features across various modalities,including fundus photography,fundus autofluorescence(FAF),optical coherence tomography(OCT),fluorescein angiography(FFA),indocyanine green angiography,and OCTA.It also explores the application of artificial intelligence in identifying CSC classifications and OCT biomarkers.Different imaging techniques have their own advantages in the diagnosis and study of cCSC,such as FAF being an effective means to assess disease progression and changes,OCT providing a more intuitive observation of retinal structural changes,FFA being an important tool for identifying leakage points,and OCTA possibly being the best means to assess choroidal microcirculation.These MMI research advancements offer crucial insights for clinicians,aiding in more accurate diagnosis and effective treatment,thereby potentially improving patient outcomes and quality of life.

关 键 词：慢性中心性浆液性脉络膜视网膜病变 多模式影像 综述 

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