新型谱域光学相干断层扫描在中心性浆液性脉络膜视网膜病变的应用

目的 为加深对中心性浆液性脉络膜视网膜病变临床特点的了解,并探讨新型谱域OCT的应用价值.方法 分析对象为2008年10月至2009年4月间确诊为中心性浆液性脉络膜视网膜病变的患者,眼底检查呈典型的中浆表现,且病变累及黄斑中心,并经OCT确诊;同时不合并其他眼病和眼内和巩膜手术史.所有患者接受了最佳矫正视力、眼底和OCT的检查;我们进一步测量了黄斑中心视网膜的各项定量指标;从OCT结果中读取视网膜中心平均厚度(CFT)、黄斑中心1～5mm范围体积(V)、然后手工测量中心凹脱离的高度(DH).并进一步采用SPSS16.0软件将患者的OCT检查指标和临床各项检查结果进行了统计分析.结果 共有44例45只眼符合入选标准并完成了相关检查,其中女性10例10只眼,男性34例35只眼;平均年龄53.4岁;视力0.73(logmar).通过分析谱域OCT清晰的图像,除传统的发现之外还发现脱离区域视网膜外层的IS/OS层反射减弱,这一减弱同时还会累及脱离区域周边未脱离的视网膜;同时在部分患者脱离区域视网膜外侧或视网膜下腔会有颗粒状沉作物.通过统计分析发现,患者的视力与年龄和性别无相关性;OCT各种定量指标与视力关联的分析发黄斑中心平均厚度(CFT)和黄斑中心厚度与视力的密切相关(P<0.05),而其他指标与视力的相关性不大.结论 目前临床中浆患者的年龄偏大,患者黄斑脱离部位的视网膜外层受损,这一损害会累及周边未脱离的视网膜,OCT的各项量化指标中黄斑中心凹厚度和中心平均厚度指标最能反应患者视力功能.对中浆的认识仍有待提高,FD-OCT在分析中将会是有用的工具.

Clinical study of central serous choriodoretinopathy using new generation spectral-domain optic coherence tomography

Objective To improve our understanding of the clinical characteristic of central serous choriodoretinopathy (CSE) and explore the usage of new spectral-domain optical coherence tomography (OCT)Methods The patients diagnosed as CSC at our hospital from October 2008 to April 2009 were included in this study and their clinical data and OCT results were reviewed.Including criteria were typical fundus changes of CSC involving the central fovea and confirmed by OCT, without other ocular history like high myopia, intraocular surgical history.Their best correct visual acuity, OCT results were analyzed, and the fovea volume (V) was collected from the OCT readings, and the fovea thickness (FT), fovea detachment height (DH) and fovea height (FH) were measured manually from the scanning.The best correct visual acuity was also checked and changed to logma chart.SPSS 16.0 was used to further analyze all these results.Results During this period, 45 eyes from 44 patients diagnosed as CSC and with all the data available met the including criteria.Among them, 10 female (10 eyes), 34 male (35 eyes); average aged 53.4, visual acuity at 0.73 (logmar).By analyzing the high resolution images from the FD-OCT, the reflex from the IS/OS segment of the detached retina was diminished, and this reduction was also found in some patients at retinal surrounding the detachment but still attaching.Also granules were found at the outside of the detached retina.Further statistic study found that the visual acuity was closely related to the height of the fovea detachment, but not other readings including V, FH, FT and the presence of granule.Conclusions At present, the age of CSC is older than expected, the outer layer of the detached retina is damaged in most patients, and in some eyes this damaged can involve the retina around.In all the OCT readings, DH is closely related to the VA.Our understanding the CSC still need to be improved and FD-OCT is an important tool in the further studying.