中心性浆液性脉络膜视网膜病变神经上皮脱离区的频域光相干断层扫描观察

目的 观察中心性浆液性脉络膜视网膜病变(CSC)神经上皮脱离区在频域光相干断层扫描(FD-OCT)的图像特征。方法 对采用国际标准视力表、裂隙灯显微镜、直接或间接检眼镜、荧光素眼底血管造影(FFA)和吲哚青绿血管造影(ICGA)检查确诊的黄斑部有神经上皮浆液性脱离的CSC患者88例92只眼进行FD-OCT检查。采用二极管反射的红外光对眼底黄斑中心部进行线性水平扫描，扫描深度2 mm， 扫描面积6 mm×6 mm，轴向分别率5 μm，横向分辨率18 μm，扫描模式512×128。对比分析患者的FFA、ICGA检查资料，重点观察神经上皮脱离区域的FD-OCT图像特征。结果 所有患眼均有神经上皮的隆起与视网膜色素上皮(RPE)光带分离及脱离区内RPE光带的异常改变。其中，色素上皮脱离(PED)83只眼，占90.22%；RPE有结节状突起改变68只眼，占73.91%；PED灶有RPE局部缺损5只眼，占5.43%。神经上皮脱离腔内有细小尘状反光点36只眼，占39.14%。其中簇状分布17只眼（17.61%），柱状8只眼（8.69%），环形6只眼（6.52%），团块状5只眼（5.43%）。神经上皮脱离区内有较多颗粒状强反光物质59只眼，占64.14%。结论 CSC的FD-OCT特征为RPE的光带分离及脱离区的RPE光带异常。FD-OCT能准确地发现CSC神经上皮脱离区内视网膜组织的各种细微形态学改变。

Morphologic changes of central serous chorioretinopathy evaluated by Fourier-domain optical coherence tomography

Objective To evaluate the morphological changes of retinal neuroepithelium of central serous chorioretinopathy (CSC) by Fourier-domain optical coherence tomography(FD-OCT). Methods FD-OCT scan was performed on 92 eyes of 88 patients with CSC. The CSC diagnosis was established by international visual acuity chart, slit-lamp microscope, direct/indirect ophthalmoscope, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA). 6 mm horizontal line OCT scan was performed utilizing the infrared light emitted by diode, the scan depth was 2 mm with a 6 mm × 6 mmtransverse area. The vertical and horizontal resolution was 5 μm and 18/.tin respectively. The scan mode was 512× 128. Results The uplift of retinal neuroepithelium, separation or abnormal band of retinal pigment epithelial (RPE) were found in all eyes. There were 83 eyes (90. 22%) of pigment epithelial detachment (PED), 68 eyes (73.91%) of nodular protruding of RPE, 5 eyes (5. 43%) of localized RPE defects in the PED lesion, 36 eyes (39.14%) of dust-like reflects in the subretinal space and 59 eyes (64. 14%) of granular deposits in the subretinal space. Conclusion Fourier-domain OCT scans can detect detailed morphologic changes in the retina of CSC patients.