光学相干断层扫描血管成像在慢性中心性浆液性脉络膜视网膜病变合并隐匿性脉络膜新生血管中的诊断价值刘畅,赵玥,姚牧笛,曹国凡*南京医科大学眼科医院,江苏 南京 210029?通信作者(Corresponding auther),E-mail：caoguofan587@163.com

目的：研究光学相干断层扫描血管成像(Optical Coherence Tomogrence Tomographic Angiography, OCTA)在慢性中心性浆液性脉络膜视网膜病变（Chronic central serous chorioretinopathy, CCSCR）合并隐匿性脉络膜新生血管（choroidal neovascularization，CNV）的诊断价值， 并总结其OCTA影像学特征。方法：收集我院确诊为CCSCR的患者30例30眼，所有患者均行视力、眼底照相、荧光素眼底血管造影（fundus fluorescein angiography，FFA）、吲哚青绿血管造影（indocyan-nine green angiograph，ICGA）、频域光学相干断层扫描仪（Spectralis OpticaI Coherence Tomography，Spectralis OCT）及光学相干断层扫描血管造影（optical coherence tomogrence tomographic angiography, OCTA）检查，回顾性分析患者临床资料。结果：30名患者（30只患眼）中，FFA的影像学特征表现为中浆特征性的高荧光渗漏，但结合ICGA和频域OCT的影像学特征并未发现明显的CNV形态及荧光渗漏表现。其中，9只患眼在OCTA中显示脉络膜毛细血管层出现异常新生血管，B-scan扫描的定性分析显示视网膜色素上皮层（retinal pigment epithelium，RPE）下方血流信号丰富，证实了其血管化性质。另外的21只患眼在OCTA中显示脉络膜血液循环正常，未见明显CNV形成；结论：OCTA可以分层观察视网膜和脉络膜，了解CCSCR黄斑区微血管异常，提高CCSCR合并隐匿性CNV的诊断率；在无法行眼底血管造影检查或眼底血管造影检查不能明确隐匿性CNV的存在时，OCTA可以发挥其快捷无创的优势，帮助CCSCR合并隐匿性CNV的鉴别诊断

Diagnostic value of optical coherence tomography angiography for chronic central serous chorioretinopathy with occult choroidal neovascularizationLiu Chang, Zhao Yue, Yao Mudi, Cao Guofan*

Purpose: To evaluate the value of optical coherence tomogrence tomographic angiography (OCTA) in the diagnosis of chronic central serous chorioretinopathy (CCSCR) with occult choroidal neovascularization (CNV). And summarize the OCTA imaging features. Method: Retrospective analysis of the clinical data of 30 cases(30 eyes)diagnosed with chronic central serous chorioretinopathy (for at least 6 months ). Visual acuity, fundus photography, FFA, ICGA, frequency domain OCT and OCTA examinations were performed for all the patients. The image data of the B-scan results were qualitatively analyzed by the SSADA algorithm and the EN face mode. Results: The average visual acuity of patients with confirmed chronic CSCR was 20/30, and FFA showed a characteristic high fluorescence leakage area, but no evidence of CNV. In 21 eyes (group 1), OCTA showed no obvious CNV formation in the choroidal capillary layer, and the remaining 9 eyes (group 2) found abnormal angiogenesis in the choroidal capillary layer; The qualitative analysis of the OCT B scan compared with the OCTA image showed that abundant blood flow signals beneath the RPE layer in 9 patients (30%), confirming the presence of vascularization, and the remaining 21 eyes (70%) showed normal choroidal blood circulation. Conclusions: OCTA can detect the small changes of capillary and microvascular abnormality in the macular area of CCSCR non-invasively and quickly. The greatest advantage is that the lesions indifferent layers can be seen. When occult CNV occurred, OCTA can discover choroidal neovascular plexus that cannot be found by other imaging techniques. Therefore, OCTA can greatly give significant help for CCSCR treatmentand give patients better visual rehabilitation.