老年中心性浆液性脉络膜视网膜病变的光学影像学表现

目的:观察老年中心性浆液性脉络膜视网膜病变(central serouschorioretinopathy,CSC)的光学影像学表现。方法:回顾性分析2008-01/2009-06在我科经眼底荧光血管造影(fundus fluorescein angiography,FFA)、吲哚青绿血管造影(indocyanine green angiography,ICGA)及光相干断层扫描(optical coherence tomography,OCT)共同确诊的17例18眼老年CSC患者的临床资料。结果:老年CSC患者具有与中青年患者相同的FFA,ICGA及OCT改变;也具有一些其独自的特征性改变,主要表现为:(1)FFA检查发现CSC病变所表现的典型RPE渗漏形式,如炊烟状或墨渍样少见,仅占39%;其他11眼(61%)均表现为扩散性视网膜色素上皮病变;(2)ICGA检查发现其黄斑部还合并一些其他改变,如多灶性浆液性色素上皮脱离(pigment epithelium detachment,PED),息肉样脉络膜血管扩张,脉络膜毛细血管萎缩等;(3)FD-OCT检查发现其黄斑部也合并一些其他改变,如玻璃膜疣引起的RPE结节状隆起,多灶性视网膜萎缩、及IS/OS层的局部缺失等。结论:老年CSC患者的光学影像学表现复杂,容易与老年性黄斑变性相混淆,同步FFA及ICGA检查联合OCT检查有助于确诊。

Optical imaging features of elderly central serous chorioretinopathy

AIM:To observe the optical imaging features of the elderly central serous chorioretinopathy (CSC).·METHODS:The clinical data of 17 cases (18 eyes) of elderly patients with CSC diagnosed by fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were analyzed retrospectively during Jan.2008-Jun.2009.·RESULTS:The elderly patients had the same FFA,ICGA and OCT changes with the middle-aged patients with CSC,but also had some of its own characteristic changes.(1)The FFA found the rate of the typical RPE leakage form such as smoke or ink stain was seldom,only 39%.The other 11 eyes(61%) showed diffuse retinal pigment epithelial lesion;(2)The ICGA found there were some other changes which differentiated from the CSC,such as the serous pigment epithelium detachment (PED),polyp-like choriodal vessel dilation,and choriocapillaris atrophy;(3) The (Fourier Domain) FD-OCT also found some other changes besides the CSC lesions,including nodular eminence of the RPE layer corresponding to drusen,multifocal retinal atrophy,and the (inner and outer segment) IS/OS layer atrophy partly.·CONCLUSION:The elderly patients with CSC has complex changes in optical imaging,and it can be easily confused with age-related macular degeneration.The FFA and ICGA combined with OCT examination are helpful for diagnosis.