中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2012年
9期
1049-1053
,共5页
毛爱玲%周才喜%魏炜%杨绍辉%冯娜
毛愛玲%週纔喜%魏煒%楊紹輝%馮娜
모애령%주재희%위위%양소휘%풍나
中心性浆液性脉络膜视网膜病变%荧光素血管造影%频域光相干断层扫描%诊断显像
中心性漿液性脈絡膜視網膜病變%熒光素血管造影%頻域光相榦斷層掃描%診斷顯像
중심성장액성맥락막시망막병변%형광소혈관조영%빈역광상간단층소묘%진단현상
Central serous chorioretinopathy/diagnosis%Fluorescein angiography%Optical coherence%Diagnostic imaging
目的 观察眼底伴有灰色病灶的急性中心性浆液性脉络膜视网膜病变(CSC)的光学影像学特征.方法 回顾分析经直接和间接检眼镜、眼底照相、荧光素眼底血管造影(FFA)、吲哚青绿血管造影(ICGA)、频域光相干断层扫描(FD-OCT)检查确诊的23例眼底伴有灰色病灶的急性CSC患者26只眼的临床资料,对比观察彩色眼底像、FFA、ICGA、FD-OCT检查结果,重点观察灰色病灶在各种检查中的光学影像表现.结果 FFA早期所有患眼的灰色病灶处均有1～3个不等的活动性视网膜色素上皮(retinal pigment epithelium,RPE)渗漏点出现,后期病灶均呈强荧光着色；ICGA早期所有患眼的灰色病灶及其周围的脉络膜血管区域性充盈迟缓,呈斑片状弱荧光,且弱荧光灶内也有强荧光漏点出现,与FFA中RPE渗漏点相对应.其中,23只眼弱荧光灶内还有脉络膜血管扩张,呈条带状强荧光,占88.46％；5只眼伴有小叶状脉络膜毛细血管扩张,呈斑片状强荧光,占15.39％.ICGA后期,灰色病灶处亦均呈强荧光着色.FD-OCT检查,所有患眼灰色病灶对应处神经上皮下脱离腔内有柱状、环形中高等光反射物质连接于神经上皮和色素上皮脱离(PED)灶之间.其中,5只眼有RPE局部断裂,占15.39％.结论 眼底伴有灰色病灶的急性CSC有其独自的光学影像学特征,表现为:(1) FFA早期灰色病灶处有活动性RPE渗漏点出现,而后期呈强荧光染色；(2) ICGA早期灰色病灶处脉络膜血管表现为灌注不良或高灌注,后期亦呈强荧光染色；(3) FD-OCT显示灰色病灶处神经上皮下脱离腔内有中高等光反射物质分布,可伴有RPE局部断裂.
目的 觀察眼底伴有灰色病竈的急性中心性漿液性脈絡膜視網膜病變(CSC)的光學影像學特徵.方法 迴顧分析經直接和間接檢眼鏡、眼底照相、熒光素眼底血管造影(FFA)、吲哚青綠血管造影(ICGA)、頻域光相榦斷層掃描(FD-OCT)檢查確診的23例眼底伴有灰色病竈的急性CSC患者26隻眼的臨床資料,對比觀察綵色眼底像、FFA、ICGA、FD-OCT檢查結果,重點觀察灰色病竈在各種檢查中的光學影像錶現.結果 FFA早期所有患眼的灰色病竈處均有1～3箇不等的活動性視網膜色素上皮(retinal pigment epithelium,RPE)滲漏點齣現,後期病竈均呈彊熒光著色；ICGA早期所有患眼的灰色病竈及其週圍的脈絡膜血管區域性充盈遲緩,呈斑片狀弱熒光,且弱熒光竈內也有彊熒光漏點齣現,與FFA中RPE滲漏點相對應.其中,23隻眼弱熒光竈內還有脈絡膜血管擴張,呈條帶狀彊熒光,佔88.46％；5隻眼伴有小葉狀脈絡膜毛細血管擴張,呈斑片狀彊熒光,佔15.39％.ICGA後期,灰色病竈處亦均呈彊熒光著色.FD-OCT檢查,所有患眼灰色病竈對應處神經上皮下脫離腔內有柱狀、環形中高等光反射物質連接于神經上皮和色素上皮脫離(PED)竈之間.其中,5隻眼有RPE跼部斷裂,佔15.39％.結論 眼底伴有灰色病竈的急性CSC有其獨自的光學影像學特徵,錶現為:(1) FFA早期灰色病竈處有活動性RPE滲漏點齣現,而後期呈彊熒光染色；(2) ICGA早期灰色病竈處脈絡膜血管錶現為灌註不良或高灌註,後期亦呈彊熒光染色；(3) FD-OCT顯示灰色病竈處神經上皮下脫離腔內有中高等光反射物質分佈,可伴有RPE跼部斷裂.
목적 관찰안저반유회색병조적급성중심성장액성맥락막시망막병변(CSC)적광학영상학특정.방법 회고분석경직접화간접검안경、안저조상、형광소안저혈관조영(FFA)、신타청록혈관조영(ICGA)、빈역광상간단층소묘(FD-OCT)검사학진적23례안저반유회색병조적급성CSC환자26지안적림상자료,대비관찰채색안저상、FFA、ICGA、FD-OCT검사결과,중점관찰회색병조재각충검사중적광학영상표현.결과 FFA조기소유환안적회색병조처균유1～3개불등적활동성시망막색소상피(retinal pigment epithelium,RPE)삼루점출현,후기병조균정강형광착색；ICGA조기소유환안적회색병조급기주위적맥락막혈관구역성충영지완,정반편상약형광,차약형광조내야유강형광루점출현,여FFA중RPE삼루점상대응.기중,23지안약형광조내환유맥락막혈관확장,정조대상강형광,점88.46％；5지안반유소협상맥락막모세혈관확장,정반편상강형광,점15.39％.ICGA후기,회색병조처역균정강형광착색.FD-OCT검사,소유환안회색병조대응처신경상피하탈리강내유주상、배형중고등광반사물질련접우신경상피화색소상피탈리(PED)조지간.기중,5지안유RPE국부단렬,점15.39％.결론 안저반유회색병조적급성CSC유기독자적광학영상학특정,표현위:(1) FFA조기회색병조처유활동성RPE삼루점출현,이후기정강형광염색；(2) ICGA조기회색병조처맥락막혈관표현위관주불량혹고관주,후기역정강형광염색；(3) FD-OCT현시회색병조처신경상피하탈리강내유중고등광반사물질분포,가반유RPE국부단렬.
Objective To observe the optical imaging features of the acute central serous chorioretinopathy (CSC) with grayish lesion.Methods The data of 23 patients (26 eyes) diagnosed as acute CSC by direct/indirect ophthalmoscope,color fundus photograph,fluorescence fundus angiography (FFA),indocyanine green angiography (ICGA) and fourier-domain optical coherence tomography (FD-OCT) were retrospectively analyzed.The appearances of the grayish lesions in the color fundus photograph,FFA,ICGA and FD-OCT were mainly observed by contrast to analyze their relations.Results One to three retinal pigment epithelium (RPE) active leakage sites presented at the site of the grayish lesion of 26 eyes (100.00％) in the early and the lesions showed strong staining in the later during the FFA.The location of the grayish lesion showed plaque hypofluorescence in which the chorioidal artery delayed filling and there also had ICG dye leakage which were accord with the RPE active leakage sites in the FFA in 26 eyes (100.00％) in the early during the ICGA.Within the lesions,there were strip hyperfluorescence focus appearing in 23 eyes (88.46％) and plaque hyperfluorescence focus in 5 eyes (15.39％) because of the choroidal vein dilated and the choriocapillary dilated in the site of the grayish lesion respectively.The grayish lesion also showed hyperfluorescence due to the tissue stained in the later during the ICGA.In the FD-OCT,there were moderate or high reflective masses bridging the neurosensory retina and the pigment epithelial detachment (PED) which showed pillar or circle shape in the site of grayish lesion in 26 eyes (100.00％),and the RPE of PED were broken partly in 5 eyes (15.39％).Conclusions The acute CSC with grayish lesion has its own optical imaging characteristics.There are RPE active leakage sites appearing in the location of the grayish lesions in the early and the tissue strong staining in the late during the FFA.The choroidal vessels perfuse poorly or high in the early and the tissue also strong staining in the late during the ICGA.There are moderate or high reflective masses bridging the neurosensory retina and the PED beneath the detached neurosensory retina at the area of grayish lesion,the PED may be associated with RPE broken partialy in the FD-OCT.
