眼底血管造影和OCT结合对CEC脉络膜新生血管分型的评估

目的应用荧光素眼底血管造影（FFA）、吲哚青绿血管造影（ICGA）和光学相干断层扫描（OCT）3种影像检查评估中心性渗出性脉络膜视网膜病变（CEC）脉络膜新生血管（CNV）的分型和性质。方法采用FFA、ICGA和Strastus-TM型OCT仪3种检查观察并相互印证53例（56眼）CEC患者的CNV的形态及类型。结果FFA图像显示,典型性CNV25眼（44.64%）,部分典型性CNV11眼（19.64%）;隐匿性CNV2眼（3.57%）,其中纤维血管性色素上皮脱离型（F-PED）1眼,晚期无源性渗漏1眼,CNV瘢痕化13眼（23.21%）。ICGA图像显示,19眼（33.93%）在ICGA与FFA早期同时显示CNV,7眼（12.5%）FFA为非典型性CNV,ICGA表现为焦点状或边界清晰的斑状,1眼ICGA早期显示病灶周围及后极部伴有限局性脉络膜血管扩张,10眼（17.85%）在ICGA晚期显示弱荧光环;CNV瘢痕化9眼（16.07%）。OCT显示,21眼（37.5%）CNV呈类圆形团块位于视网膜神经上皮下间隙;22眼（39.29%）的CNV呈纺锤形或不规则形位于色素上皮层平面;1眼（4.76%）为不规则、松散、边界不清的中等或高光反射组织;9眼（19.64%）色素上皮完整、连续,其下中等强度反射,局部视网膜隆起或不隆起。33眼伴有浆液性神经上皮脱离;2眼伴有出血性色素上皮脱离。结论采用眼底血管造影和OCT相结合评判CNV的状况可以明确病情,提供治疗的依据。

The application of fundus angiography and OCT in the classification of choroidal neovascularization complicated in central exudative choretinopathy

Objective The aim of present study was to investigate the classification and characteristics of choroidal neovascularization（CNV） in central exudative chorioretinopathy by fundus fluorescein angiography （FFA）, indoeyanine green angiography（ICGA） and optical coherence tomography （OCT）. Methods A series of retrospective study was designed. FFA, ICGA and OCT were performed in 53 patients （56 eyes） with central exudative choretinopathy. The types and characteristics of CNV were evaluated by method mentioned above. Results FFA showed that CNV was categorized as classic CNV in 25 eyes （44. 64% ） ,partial classic CNV in 11 eyes （ 19.64% ） and occult CNV in 2 eyes （ 3.57% ） , including fibrovascular pigment epithelial detachment （F-PED） in 1 eye,late leakage of undetermined source in 1 eye, and CNV fibrosis in 13 eyes （23.21% ）. FFA and ICGA indicated classic CNV early phase in 19 eyes（33.93% ） ,and 7 eyes （12.5%） with ill-defined CNV in FFA showed well-defined CNV in hypofluorescent area. Local dilatation of choroidal vessels around lesions and posterior pole was exhibited early-phase of ICGA in 1 eye, and 10 eyes（ 17.85% ） appeared a dark rim surrounding CNV in the late phase of ICGA. CNV fibrosis was found in 9 eyes （ 16.07% ）. Based on the location of CNV by OCT, CNV appeared in subretinal space anterior to the retinal pigment epithelium as highly or moderately reflective mass, which protruded from the retinal pigment epithelium in 21 eyes. In 22 eyes,CNV appeared as a highly reflective fusiform or irregular mass at the level of retinal pigment epithelium and ehoriocapillaris. CNV was displayed as a highly or moderately irregular and incompact reflective mass in 1 eye and only moderately reflective mass under the retinal pigment epithelium in 9 eyes. Thirty-three eyes were associated with serous neurosensory retina detachment,and 2 eyes presented hemorrhagic pigment epithelium detachment （PED）. Conclusion Combination of FFA, ICGA and OCT is helpful in classi