中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2011年
8期
724-727
,共4页
张静琳%吴德正%吴斌斌%姚翠群%高汝龙%何蜀莹
張靜琳%吳德正%吳斌斌%姚翠群%高汝龍%何蜀瑩
장정림%오덕정%오빈빈%요취군%고여룡%하촉형
中心性浆液性脉络膜视网膜病变%光学相干断层扫描%荧光素眼底血管造影
中心性漿液性脈絡膜視網膜病變%光學相榦斷層掃描%熒光素眼底血管造影
중심성장액성맥락막시망막병변%광학상간단층소묘%형광소안저혈관조영
Central serous chorioretinopathy%Optical coherence tomography%Fundus fluorescein angiography
背景 以往中心性浆液性脉络膜视网膜病变(CSC)的确诊主要依靠荧光素眼底血管造影(FFA),而光学断层相干扫描(OCT)与FFA的联合应用为CSC的动态观察及评价其发病机制提供了新的途径.目的 通过将CSC患者的FFA图像导人OCT中,研究2种检查方法定位病变部位的一致性,探讨CSC的发病机制.方法 44例单眼诊断为CSC的患者纳入本研究,包括男36例,女8例;年龄(39.3±5.3)岁,视力0.64±0.27.所有患者均进行了 FFA和OCT检查.在Topcon 3D OCT 1000中导入FFA图像,直接对照OCT病灶与FFA渗漏点,观察二者病变部位的一致性,并用OCT方法测量中心凹神经上皮厚度及其脱离高度.结果 OCT显示视网膜色素上皮(RPE)的改变包括RPE脱离34例(77.3%),RPE小隆起和粗糙10例(22.7%);在RPE脱离的34眼中OCT与FFA定位一致者占31例31眼(91.2%),2种结果不一致者为3例3眼(8.8%).OCT检测CSC患眼中心凹神经上皮层的厚度为(138.5±19.40)pm,与正常眼的(137.35±5.01)μm比较,差异无统计学意义(t=0.39,P＞0.05);神经上皮层脱离的高度为(263.3±126.7)μm.结论 CSC的病理机制为RPE脱离继发黄斑区神经上皮脱离,FFA渗漏点基本与OCT所测RPE脱离的部位相对应.无RPE脱离者可能与RPE通透性改变有关,OCT能精确测量中心凹神经上皮厚度及脱离的高度.
揹景 以往中心性漿液性脈絡膜視網膜病變(CSC)的確診主要依靠熒光素眼底血管造影(FFA),而光學斷層相榦掃描(OCT)與FFA的聯閤應用為CSC的動態觀察及評價其髮病機製提供瞭新的途徑.目的 通過將CSC患者的FFA圖像導人OCT中,研究2種檢查方法定位病變部位的一緻性,探討CSC的髮病機製.方法 44例單眼診斷為CSC的患者納入本研究,包括男36例,女8例;年齡(39.3±5.3)歲,視力0.64±0.27.所有患者均進行瞭 FFA和OCT檢查.在Topcon 3D OCT 1000中導入FFA圖像,直接對照OCT病竈與FFA滲漏點,觀察二者病變部位的一緻性,併用OCT方法測量中心凹神經上皮厚度及其脫離高度.結果 OCT顯示視網膜色素上皮(RPE)的改變包括RPE脫離34例(77.3%),RPE小隆起和粗糙10例(22.7%);在RPE脫離的34眼中OCT與FFA定位一緻者佔31例31眼(91.2%),2種結果不一緻者為3例3眼(8.8%).OCT檢測CSC患眼中心凹神經上皮層的厚度為(138.5±19.40)pm,與正常眼的(137.35±5.01)μm比較,差異無統計學意義(t=0.39,P＞0.05);神經上皮層脫離的高度為(263.3±126.7)μm.結論 CSC的病理機製為RPE脫離繼髮黃斑區神經上皮脫離,FFA滲漏點基本與OCT所測RPE脫離的部位相對應.無RPE脫離者可能與RPE通透性改變有關,OCT能精確測量中心凹神經上皮厚度及脫離的高度.
배경 이왕중심성장액성맥락막시망막병변(CSC)적학진주요의고형광소안저혈관조영(FFA),이광학단층상간소묘(OCT)여FFA적연합응용위CSC적동태관찰급평개기발병궤제제공료신적도경.목적 통과장CSC환자적FFA도상도인OCT중,연구2충검사방법정위병변부위적일치성,탐토CSC적발병궤제.방법 44례단안진단위CSC적환자납입본연구,포괄남36례,녀8례;년령(39.3±5.3)세,시력0.64±0.27.소유환자균진행료 FFA화OCT검사.재Topcon 3D OCT 1000중도입FFA도상,직접대조OCT병조여FFA삼루점,관찰이자병변부위적일치성,병용OCT방법측량중심요신경상피후도급기탈리고도.결과 OCT현시시망막색소상피(RPE)적개변포괄RPE탈리34례(77.3%),RPE소륭기화조조10례(22.7%);재RPE탈리적34안중OCT여FFA정위일치자점31례31안(91.2%),2충결과불일치자위3례3안(8.8%).OCT검측CSC환안중심요신경상피층적후도위(138.5±19.40)pm,여정상안적(137.35±5.01)μm비교,차이무통계학의의(t=0.39,P＞0.05);신경상피층탈리적고도위(263.3±126.7)μm.결론 CSC적병리궤제위RPE탈리계발황반구신경상피탈리,FFA삼루점기본여OCT소측RPE탈리적부위상대응.무RPE탈리자가능여RPE통투성개변유관,OCT능정학측량중심요신경상피후도급탈리적고도.
Background The diagnosis of central serous chorioretinopathy (CSC) is mainly dependent onfluorescine fundus angiography (FFA). However, the combination of optical coherence topography (OCT) with FFA offers a new approach to the research of the pathogenesis of CSC. Objective This clinical study was designed to study the combined application of the FFA and OCT for the research of the pathogenesis of central serous chorioretinopathy (CSC). Methods Forty-four eyes of 44 patients with CSC were included in this study with 36 cases of males and 8 cases of female. The patients were aged 39.3 ± 5.3 years and the visual acuity was 0. 64 ±0. 27. FFA and OCT examinations were performed in all patients and the FFA images were imported into the Topcon 3D OCT 1000 device to locate the conformity of OCT lesions with the leakages of FFA. The neuroepithelial layer thickness at the fovea and the height of the neuroepithelial layer detachment were measured using 3-D OCT. Results OCT showed serous REP detachment in 34 eyes (77.3%) and rough surfaces of RPE in 10 eyes (22. 7% ). In thirtyfour eyes with RPE detachment, the OCT lesions and FFA leakage spots conformed to the same locations in 31 eyes, but the other three eyes did not. The mean foveal neuroepithelial thickness was (138.5±19.4) μm in CSC eyes and that of normal eyes was ( 131.35±5. 01 ) μm ,showing a significant difference between them( t=0. 39 ,P＞0. 05 ). The mean height of neuroepithelial detachment was (263.3 ± 126.7 ) μm in CSC eyes. Conclusion RPE detachment occurs in CSC eyes and further induces macular neuroepithelial detachment. Leakage lesion of fluorescine corresponds to RPE detachment. CSC without RPE detachment may be related to the increase in RPE permeability. OCT can accurately measure the thickness of the macular neuroepithelial layer and the height of the neuroepithelial detachment.
