局灶性脉络膜凹陷的临床特征分析

目的　观察局灶性脉络膜凹陷（ｆｏｃａｌｃｈｏｒｏｉｄａｌｅｘｃａｖａｔｉｏｎ，ＦＣＥ）的临床特征。方法　回顾性分析１６例（１７眼）临床确诊的ＦＣＥ患者的临床资料。所有患者行最佳矫正视力（ｂｅｓｔ-ｃｏｒｒｅｃｔｅｄｖｉｓｕａｌａｃｕｉｔｙ，ＢＣＶＡ）、裂隙灯显微镜、间接眼底镜检查及光学相干断层扫描检查，部分患者行眼底彩色照相检查、眼底荧光血管造影、吲哚青绿血管造影（ｉｎｄｏｃｙａ-ｎｉｎｅｇｒｅｅｎａｎｇｉｏｇｒａｐｈｙ，ＩＣＧＡ）检查。结果　１６例患者中男１１例（６８．８％），女５例（３１．２％）；年龄２５～７５（４３．５６±１２．５３）岁；双眼１例，单眼１５例。１７眼中，正视６眼（３５．３％），近视１１眼（６４．７％）。患眼初诊ＢＣＶＡ０．２～１．０（０．６９±０．２２）。眼底检查ＦＣＥ处表现为大致正常、不同程度脱色素或黄白色病灶。光学相干断层扫描检查示１６眼为单一ＦＣＥ，１眼有２处ＦＣＥ；９眼（５２．９％）为偏中心凹型ＦＣＥ，８眼（４７．１％）为中心凹下型ＦＣＥ。ＦＣＥ病灶处眼底荧光血管造影呈透见荧光或者大致正常，ＩＣＧＡ呈程度不同的低荧光。结论　ＦＣＥ多单眼发病，也可双眼发病；与屈光状态无显著相关性；视力可正常或不同程度下降；ＦＣＥ处眼底表现为不同程度脱色素或黄白色改变，也可大致正常。

Clinical characteristics of focal choroidal excavation

Objective To evaluate the clinical characteristics of focal choroidal excavation ( FCE) . Methods Retrospective observational case series. The medical records of 16 patients ( 17 eyes) with FCE were reviewed. A1l patients underwent the examination of slit lamp biomicroscopy , indirect ophthalmoscopy , best-corrected visual acuity ( BCVA) and optic coherence tomography ( OCT). Parts of them performed the examination of color photography,fundus fluorescern angiography ( FFA) and indocyanine green angiography ( ICGA) . Results The 16 patients included 5 female ( 31. 2% ) and 11 male (68. 8% ) ,the age was (43. 56 + 12. 53) years ( ranged from 25 years t0 75 years) . One patient had bilateral involvement. Six eyes ( 35. 3% ) were emmetropic , and the others ( 64. 7% ) were myopic. The mean BCVA was 0. 69 +0. 22 ( ranged from 0. 2 t0 1. 0) . Clinical examination and color photography showed varied degrees of foveal pigmentary alterations, a yellowish spot or invariable at the edge of the fovea. OCT scans revealed that 16 eyes had a single FCE and I eye had two FCE. OCT revealed the FCE was located in subfovea in 8 eyes (47. 1% ) ; In the other 9 eyes ( 52. g% ) ,it was eccentric. Corresponding to the FCE ,FFA revealed a window defect or invariable problems , whereas hypofluorescence could be found on ICGA images. Conclusion Most of patients have unilateral involvement and secondly bilateral involvements. FCE might be not distinctly related to the refraction. The visual acuity is normal or impaired at different degrees. Clinical examination and color photography show varied degrees of foveal pigmentary alterations , a yellowish spot or invariable.