急性中心性浆液性脉络膜视网膜病变的频域光相干断层扫描特征

目的 观察急性中心性浆液性脉络膜视网膜病变(CSC)频域光相干断层扫描(FD-OCT)的图像特征.方法 对比分析31例单眼急性CSC患者的FD-OCT以及荧光素眼底血管造影(FFA)检查资料.观察患眼FFA检查发现的渗漏点视网膜色素上皮(RPE)层、视网膜脱离区域以及对侧无症状眼RPE层的FD-OCT图像特征.结果 31只患眼中,FFA检查共发现荧光渗漏点34个.其中,RPE层面18个,占52.9%.荧光渗漏点在FD-OCT图像中表现为色素上皮脱离(PED)者17只眼,占54.8%;8只眼8个渗漏点表现为RPE层突起,分别占患眼及渗漏点的25.8%、23.5%;4只眼的6个渗漏点表现为RPE层不规则,分别占患眼及渗漏点的12.9%、17.6%;2只眼2个渗漏点表现为RPE层无明显异常,分别占患眼及渗漏点的6.5%、5.9%.其中,7只眼7个渗漏点见RPE层缺损,分别占患眼及渗漏点的22.6%、20.6%.所有患眼均可检测到后极部浆液性视网膜脱离以及光感受器内外节(IS/OS)层强反光带的断裂或消失.24只眼可见外节(0S)层厚度不均,占77.4%;10只眼可见外节层剥脱样改变,占32.3%;8只眼可见视网膜神经上皮外层以及RPE表面的颗粒样强反光点,占25.8%.0S层厚度不均的24只眼中,14只眼可见下垂征.31只无症状对侧眼中,11只眼存在RPE异常,占35.5%.其中,2只眼为PED,占无症状对侧眼的6.5%;1只跟为RPE层突起,占无症状对侧眼的3.2%;8只眼表现为RPE层不规则,占无症状对侧眼的25.8%.结论 急性CSC患眼渗漏点处RPE层的FD-OCT图像特征为PED、RPE层突起、RPE层不规则、RPE层无明显异常.视网膜脱离区域FD-OCT图像特征为浆液性视网膜脱离、IS/OS层断裂或消失、OS层厚度不均、OS层剥脱样改变、视网膜神经上皮外层以及RPE表面颗粒样强反光点.

Features of frequency domain optical coherence tomography in acute central serous chorioretinopathy

Objective To observe the features of frequency domain optical coherence tomography (FD-OCT) in acute central serous chorioretinopathy (CSC).Methods The data of FD-OCT and fundus fluorescein angiography (FFA) of 31 patients with unilateral acute CSC were retrospectively analyzed.The FD-OCT of retinal pigment epithelial (RPE) layer at leakage points, retinal detachment area and RPE layer in the fellow eyes was documented.Results Thirty-four leakage points were detected in 31 eyes on FFA.At the sites of fluorescein leakage, FD-OCT showed that serous pigment epithelial detachment (PED) in 18leakage points (52.9%) and 17 eyes (54.8%), a small RPE protrusion in 8 leakage points (23.5%) and 8eyes (25.8%), RPE irregularity in 6 leakage points (17.6%) and 4 eyes (12.9%) and no detectable RPE abnormality in 2 leakage points (5.9%) and 2 eyes (6.5%).An RPE defect at the edge of or within the fPED was found in 7 leakage points (20.6%) and 7 eyes (22.6%).Serous retinal detachment and interruption or complete disappearance of the hyper-reflective inner/outer segment junction (IS/OS) were detected in all diseased eyes.Uneven thickness of the outer segments (OS) was found in 24 eyes (77.4%),14 of which had sagging sign.Flaking of the OS was found in 10 eyes (32.3%), multiple hyper-reflective dots on the posterior surface of the detached neurosensory retina and on the surface of the RPE were found in 8 eyes (25.8%).Among 31 fellow eyes, FD-OCT also showed RPE abnormalities in 11 eyes (35.5%),in which PED, RPE protrusion and RPE irregularity were detected in 2 (6.5%), 1 (3.2%) and 8 eyes (25.8%), respectively.Conclusions In acute CSC the FD-OCT images at leakage points of are featured by PED, RPE protrusion, RPE irregularity and no detectable RPE abnormality; in retinal detachment area FD-OCT are featured by serous retinal detachment, interruption or disappearance of IS/OS, uneven thickness of OS, flaking of OS and hyper-reflective dots on the posterior surface of the detached neurosensory retina and on the surface of the RPE.