急性中心性浆液性脉络膜视网膜病变FFA与频域OCT图像对比研究

目的　观察急性中心性浆液性脉络膜视网膜病变（ｃｅｎｔｒａｌｓｅｒｏｕｓｃｈｏｒｉｏｒｅｔｉ－ｎｏｐａｔｈｙ，ＣＳＣ）荧光素眼底血管造影（ｆｕｎｄｕｓｆｌｕｏｒｅｓｃｅｉｎａｎｇｉｏｇｒａｐｈｙ，ＦＦＡ）和频域光学相干断层扫描（ｆｒｅｑｕｅｎｃｙｄｏｍａｉｎｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ，ＦＤ－ＯＣＴ）图像特征，对比研究２种检查方法定位病灶的一致性。方法　回顾性分析７９例急性ＣＳＣ患者（８１眼）的ＦＦＡ和ＦＤ－ＯＣＴ图像资料，观察患眼ＦＦＡ荧光素渗漏点与ＦＤ－ＯＣＴ中视网膜色素上皮（ｒｅｔｉｎａｌｐｉｇｍｅｎｔｅｐｉｔｈｅｌｉｕｍ，ＲＰＥ）异常改变的对应关系。结果　８１眼急性ＣＳＣ患眼中，ＦＦＡ检查发现荧光素渗漏点８６个，在ＦＤ－ＯＣＴ图像上表现为视网膜色素上皮脱离（ｐｉｇｍｅｎｔｅｐｉｔｈｅｌｉａｌｄｅｔａｃｈｍｅｎｔ，ＰＥＤ）、小隆起、粗糙紊乱等ＲＰＥ层异常改变。此外尚有１３眼（１６．０５％）在荧光素渗漏点以外区域存在着低荧光、荧光染色、透见荧光，在ＦＤ－ＯＣＴ上ＲＰＥ亦表现为ＰＥＤ、小隆起、粗糙紊乱混合存在。还有６眼（７．４１％）无任何异常荧光区域，在ＦＤ－ＯＣＴ上ＲＰＥ也显示有ＰＥＤ、小隆起、粗糙紊乱等改变。结论　急性ＣＳＣ的ＦＦＡ渗漏点与ＦＤ－ＯＣＴ中ＲＰＥ异常改变部位基本对应，而ＦＦＡ渗漏点以外区域ＦＤ－ＯＣＴ亦有ＲＰＥ层异常改变，在急性ＣＳＣ诊治中ＦＤ－ＯＣＴ不可完全替代ＦＦＡ。

A comparative study on image of FFA and FD-OCT in acute central serous chorioretinopathy

Objective To observe and compare the image features and their correlation of fundus fluorescein anglograph ( FFA) and frequency domain optical coherence tomography ( FD-OCT) in acute central serous chorioretinopathy ( CSC) . Methods The data of FFA and FD-OCT of 79 cases (81 eyes) with acute CSC were retrospective analyzed. The corresponding relations between leakage points on FFA and abnormal changes of retinal pigment epithelium ( RPE) layer on FD-OCT were observed. Results Eighty-six leakage points were detected in 81 eyes on FFA, for which FD-OCT all showed abnormal changes of RPE layer , such as pigment epithelial detachment ( PED) , a small RPE layer protrusion and RPE layer irregularity disorder. In addition , outside of the fluorescence leakage, they showed low fluorescence and fluorescence stairung and window defect in 13 eyes ( 16. 05% ) of 81 eyes. FD-OCT often showed PED.a small RPE layer protrusion and RPE layer irregularity disorder nuxed and exist at the same time. Outside of fluorescence leakage, which were no any abnormal fluorescence region, FD-OCT also showed the PED . a small RPE layer protrusion , RPE layer irregularity disorder in 6 eyes ( 7. 41% ) of 81 eyes. Conclrision Leakage points on FFA corresponds to abnormal changes of RPE layer on FD-OCT. However , outside of fluorescence leakage on FFA, FD-OCT also have abnormal changes of RPE layer, FD-OCT can not completely replace FFA in acute CSC.