中心性浆液性脉络膜视网膜病变光学相干断层扫描血流成像（OCTA）的图像特征

目的　观察中心性浆液性脉络膜视网膜病变（central serous chorioretinopathy，CSC）患者的光学相干断层扫描血流成像（optical coherence tomographic angiography，OCTA）图像，分析患眼及对侧眼脉络膜的改变特征。方法　经确诊的30例单眼CSC患者及20例（20眼）正常人纳入研究，患眼30眼、对侧眼30眼及正常对照眼20眼均行常规检查及吲哚菁绿血管造影、OCTA检查。利用Optovue OCT获得OCTA图像及黄斑中心凹下脉络膜厚度（subfoveal choroidal thickness，SFCT）值，观察患眼及对侧眼的脉络膜毛细血管层图像特点及SFCT变化。结果　患眼SFCT为（423.70±72.88）μm，对侧眼SFCT为（370.70±61.97）μm，正常对照眼SFCT为（244.23±51.24）μm；患眼SFCT较对侧眼增厚（t=3.205，P＜0.05），患眼和对侧眼SFCT均较正常对照眼增厚（t=7.161，5.667；均为P＜0.05）。30只患眼中29眼（96.7%）OCTA见脉络膜毛细血管层异常血流信号，高信号范围与吲哚菁绿血管造影高灌注区域基本对应；1眼（3.3%）未见异常血流信号。其中高血流信号外环绕低血流信号7眼，低血流信号区内外均见高血流信号5眼，斑驳状高血流信号16眼，新生血管形态1眼。30只对侧眼中12眼（40.0%）见脉络膜毛细血管层异常血流信号，呈斑驳状改变；18眼（60.0%）未见异常。20只正常眼脉络膜毛细血管均表现为正常均匀的血流信号。结论　CSC的脉络膜改变主要表现为脉络膜毛细血管层的异常血流信号及SFCT增厚，部分对侧无症状眼也会出现相应改变。OCTA作为一种检查手段，在CSC的诊断、预防和病情评价中均有明确的临床应用价值。

Clinical characteristics of central serous chorioretinopathy by optical coherence tomographic angiography

Objective　To observe choroidal characteristics in the eyes affected with central serous chorioretinopathy (CSC) and the fellow eyes by optical coherence tomographic angiography (OCTA).Methods　A total of 30 patients (30 eyes) diagnosed with unilateral CSC and 20 normal subjects (20 eyes) were included in this study.All patients underwent comprehensive multimodal examinations,including conventional examinations,indocyanine green angiography (ICGA) and OCTA.By applying Optovue OCT,the characteristics of OCTA imaging and subfoveal choroidal thickness (SFCT) were obtained,the choriocapillaris level signals and SFCT changes were assessed in CSC eyes and the fellow eyes in addition.Results　The SFCT was (423.70±72.88)μm in CSC eyes,(370.70±61.97)μm in fellow eyes and (244.23±51.24)μm in normal eyes.The SFCT was thicker in CSC eyes than in fellow eyes (t=3.205,P＜0.05).The SFCT in both of CSC eyes and fellow eyes was thicker than in normal eyes (t=7.161,5.667;both P＜0.05).OCTA imaging revealed abnormal flow signals at the choriocapillaris level in 29 amongst of 30 CSC eyes (96.7%) and normal flow signals in 1 eye (3.3%) amongst of 30 CSC eyes.High flow signals in OCTA were corresponded with the choroidalhy perperfusionin ICGA.Moreover,abnormal signals had different patterns:central high-flow signal surrounded by outer low-flow signal (7 eyes),central high-flow signal surrounded by inner low-flow signal with outer high-flow signal (5 eyes),mottled flow signal (16 eyes) and choroidal neovascularization(1 eye).Abnormal signals were demonstrated at the choriocapillaris level in OCTA in 12 fellow eyes (40.0%),while 18 eyes (60.0%) had a normal pattern.Normal flow signals were revealed at the choriocapillaris level on OCTA in all 20 normal eyes.Conclusion　On the image of OCTA,the choroidal characteristics of CSC are evident,including abnormal flow signals at the choriocapillaris level and thicker SFCT.Several fellow eyes have the analogical changes.Therefore,as a clinical instrument,OCTA has definite application value in diagnosis,prevention and assessment of CSC.