中心性渗出性脉络膜视网膜病变的相干光断层扫描结果分析

目的 探讨中心性渗出性脉络膜视网膜病变(CEC)黄斑部视网膜下脉络膜新生血管(CNV)患者的相干光断层扫描(OCT)图像特征。方法 对20例(21只眼)CEC连续治疗患者进行OCT检查,并与荧光素眼底血管造影(FFA)和吲哚青绿眼底血管造影(ICGA)结果进行对比;同时对光动力治疗后患者的OCT图像形态变化进行分析,以评价OCT图像特征对CEC患者的临床治疗价值。结果 21只眼中,有16只眼CNV呈类圆形团块状,自视网膜色素上皮层向上突出,位于视网膜神经上皮下间隙,呈强或中等强度反射;5只眼的CNV呈纺锤形或不规则形,亦呈强或中等强度反射,位于色素上皮层平面。21只眼中有9只眼伴有浆液性神经上皮脱离,6只跟伴有出血性色素上皮脱离,14只眼伴有不同程度的视网膜水肿和增厚。17只眼经光动力治疗后,随访3～12个月,平均6个月,FFA检查显示荧光素渗漏消退或减弱的患者,OCT检查均显示CNV团块不同程度退缩,其形态亦发生变化。OCT图像特征与FFA和ICG检查结果有互补性。结论 OCT检查可以确定CEC患者病变中CNV团块的形态、大小及位置。CEC病变中CNV的OCT图像以突出于色素上皮层的类圆形团块为特征,其形态和大小可因治疗和观察时间而变化。

Optical coherence tomography features of central exudative chorioretinopathy

OBJECTIVE: To study the morphological features of submacular choroidal neovascularization in central exudative chorioretinopathy (CEC) using optical coherence tomography (OCT). METHODS: Using OCT, we examined 21 consecutive eyes (20 patients; 8 men, 12 women; mean age 38 years) with central exudative chorioretinopathy. Results of OCT were compared with fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA). RESULTS: Choroidal neovascularization appeared in subsensory retinal space anterior to the retinal pigment epithelium as a highly or moderately reflective mass, which protruded from the retinal pigment epithelium in 16 of 21 eyes. In five eyes, choroidal neovascularization appeared as a highly reflective fusiform or irregular mass at the level of retinal pigment epithelium and choriocapillaris. Nine of 21 eyes were associated with serous neurosensory retina detachment, 6 eyes with hemorrhagic pigment epithelium detachment (PED) and 14 eyes with edema and thickening of sensory retina. In 3-12 months (mean 6 months), choroidal neovascularization of 17 eyes with PDT regressed and its morphological features changed. The results obtained from OCT, FFA and ICGA could be supplemented with each other. CONCLUSIONS: OCT can be used to confirm the morphological features, location and size of submacular choroidal neovascularization. Choroidal neovascularization appears as a highly or moderately reflective round mass which protrudes from the retinal pigment epithelium in most cases. The morphology and the size of this mass may change after treatment and during follow-up.