中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2012年
10期
878-882
,共5页
李略%李东辉%杨治坤%卞爱玲%陈有信%董方田
李略%李東輝%楊治坤%卞愛玲%陳有信%董方田
리략%리동휘%양치곤%변애령%진유신%동방전
体层摄影术,光学相干%中心性浆液性脉络膜视网膜病变%脉络膜%荧光素血管造影术%吲哚花青绿%血管造影术
體層攝影術,光學相榦%中心性漿液性脈絡膜視網膜病變%脈絡膜%熒光素血管造影術%吲哚花青綠%血管造影術
체층섭영술,광학상간%중심성장액성맥락막시망막병변%맥락막%형광소혈관조영술%신타화청록%혈관조영술
Tomography,optical coherence%Central serous chorioretinopathy%Choroid%Fluorescein angiography%Indocyanine green%Angiography
目的 探讨中心性浆液性脉络膜视网膜病变(CSC)患者脉络膜厚度变化特征、脉络膜循环异常特点及其与视网膜色素上皮病变的关系.方法 病例对照研究.应用脉络膜深层成像相干光断层扫描(EDI-OCT)仪,测量21例(21只患眼,21只对侧眼)CSC单侧发病患者及24例(24只眼)正常对照者的黄斑中心凹及鼻、颞侧每隔500 μm直至3 mm的各部位脉络膜厚度.对21例患者行荧光素眼底血管造影(FFA)和吲哚氰绿血管造影(ICGA),并对其图像进行对比分析.对CSC患者的患眼与对侧眼的各部位脉络膜厚度进行比较,采用自身配对t检验；对CSC患者的患眼和对侧眼与正常对照眼的各部位脉络膜厚度进行比较,采用成组设计t检验.结果 21例CSC患者的患眼脉络膜厚度在黄斑中心凹处最厚,为(519.0±102.5)μm,对侧眼为(439.3±94.1)μm,患眼较对侧眼明显增厚(t=4.171,P＜0.05)；正常对照眼黄斑中心凹处脉络膜厚度为(332.0±67.3) μm,患眼和对侧眼均较正常对照眼明显增厚(t=7.125,4.441；P ＜0.05).其余测量点间两两比较差异也有统计学意义(患眼与对侧眼配对比较:t =2.544 ～3.819,P＜0.05;患眼和对侧眼与正常对照眼的成组比较:=4.797～7.816,2.487 ～5.236;P ＜0.05).FFA、ICGA检查,显示21只CSC患眼的视网膜色素上皮渗漏点均出现在相对应的脉络膜早期充盈迟缓区内,其中19只眼出现渗漏点周围脉络膜血管扩张,造影晚期所有渗漏点周围均呈现脉络膜局灶性强荧光.有6只对侧眼出现视网膜色素上皮脱离,其相对应的脉络膜部位在ICGA早期呈现脉络膜血管扩张,晚期有强荧光素渗漏.而4只患眼和11只对侧眼的脉络膜在ICGA晚期呈现强荧光素渗漏灶处,经FFA检查未见视网膜色素上皮病变.结论 CSC是脉络膜局灶性缺血、继发性脉络膜血管扩张和充血、高通透性的双眼疾患.EDI-OCT检测技术是评估CSC患者脉络膜血管高通透性且引起脉络膜厚度改变的有效手段之一.
目的 探討中心性漿液性脈絡膜視網膜病變(CSC)患者脈絡膜厚度變化特徵、脈絡膜循環異常特點及其與視網膜色素上皮病變的關繫.方法 病例對照研究.應用脈絡膜深層成像相榦光斷層掃描(EDI-OCT)儀,測量21例(21隻患眼,21隻對側眼)CSC單側髮病患者及24例(24隻眼)正常對照者的黃斑中心凹及鼻、顳側每隔500 μm直至3 mm的各部位脈絡膜厚度.對21例患者行熒光素眼底血管造影(FFA)和吲哚氰綠血管造影(ICGA),併對其圖像進行對比分析.對CSC患者的患眼與對側眼的各部位脈絡膜厚度進行比較,採用自身配對t檢驗；對CSC患者的患眼和對側眼與正常對照眼的各部位脈絡膜厚度進行比較,採用成組設計t檢驗.結果 21例CSC患者的患眼脈絡膜厚度在黃斑中心凹處最厚,為(519.0±102.5)μm,對側眼為(439.3±94.1)μm,患眼較對側眼明顯增厚(t=4.171,P＜0.05)；正常對照眼黃斑中心凹處脈絡膜厚度為(332.0±67.3) μm,患眼和對側眼均較正常對照眼明顯增厚(t=7.125,4.441；P ＜0.05).其餘測量點間兩兩比較差異也有統計學意義(患眼與對側眼配對比較:t =2.544 ～3.819,P＜0.05;患眼和對側眼與正常對照眼的成組比較:=4.797～7.816,2.487 ～5.236;P ＜0.05).FFA、ICGA檢查,顯示21隻CSC患眼的視網膜色素上皮滲漏點均齣現在相對應的脈絡膜早期充盈遲緩區內,其中19隻眼齣現滲漏點週圍脈絡膜血管擴張,造影晚期所有滲漏點週圍均呈現脈絡膜跼竈性彊熒光.有6隻對側眼齣現視網膜色素上皮脫離,其相對應的脈絡膜部位在ICGA早期呈現脈絡膜血管擴張,晚期有彊熒光素滲漏.而4隻患眼和11隻對側眼的脈絡膜在ICGA晚期呈現彊熒光素滲漏竈處,經FFA檢查未見視網膜色素上皮病變.結論 CSC是脈絡膜跼竈性缺血、繼髮性脈絡膜血管擴張和充血、高通透性的雙眼疾患.EDI-OCT檢測技術是評估CSC患者脈絡膜血管高通透性且引起脈絡膜厚度改變的有效手段之一.
목적 탐토중심성장액성맥락막시망막병변(CSC)환자맥락막후도변화특정、맥락막순배이상특점급기여시망막색소상피병변적관계.방법 병례대조연구.응용맥락막심층성상상간광단층소묘(EDI-OCT)의,측량21례(21지환안,21지대측안)CSC단측발병환자급24례(24지안)정상대조자적황반중심요급비、섭측매격500 μm직지3 mm적각부위맥락막후도.대21례환자행형광소안저혈관조영(FFA)화신타청록혈관조영(ICGA),병대기도상진행대비분석.대CSC환자적환안여대측안적각부위맥락막후도진행비교,채용자신배대t검험；대CSC환자적환안화대측안여정상대조안적각부위맥락막후도진행비교,채용성조설계t검험.결과 21례CSC환자적환안맥락막후도재황반중심요처최후,위(519.0±102.5)μm,대측안위(439.3±94.1)μm,환안교대측안명현증후(t=4.171,P＜0.05)；정상대조안황반중심요처맥락막후도위(332.0±67.3) μm,환안화대측안균교정상대조안명현증후(t=7.125,4.441；P ＜0.05).기여측량점간량량비교차이야유통계학의의(환안여대측안배대비교:t =2.544 ～3.819,P＜0.05;환안화대측안여정상대조안적성조비교:=4.797～7.816,2.487 ～5.236;P ＜0.05).FFA、ICGA검사,현시21지CSC환안적시망막색소상피삼루점균출현재상대응적맥락막조기충영지완구내,기중19지안출현삼루점주위맥락막혈관확장,조영만기소유삼루점주위균정현맥락막국조성강형광.유6지대측안출현시망막색소상피탈리,기상대응적맥락막부위재ICGA조기정현맥락막혈관확장,만기유강형광소삼루.이4지환안화11지대측안적맥락막재ICGA만기정현강형광소삼루조처,경FFA검사미견시망막색소상피병변.결론 CSC시맥락막국조성결혈、계발성맥락막혈관확장화충혈、고통투성적쌍안질환.EDI-OCT검측기술시평고CSC환자맥락막혈관고통투성차인기맥락막후도개변적유효수단지일.
Objective To evaluate the characteristics of choroidal thickness changes and abnormalities in choroidal circulation in cases of central serous chorioretinopathy (CSC).Methods This was a case control study,we measured the bilateral choroidal thickness in 21 patients with unilateral CSC and 24 eyes of 24 age-and sex-matched normal subjects using enhanced depth imaging optical coherence tonography (EDI-OCT).The choroid was measured from the posterior edge of the retinal pigment epithelium (RPE) to the choroid-scleral junction at 500 μm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea.Paired-samples t-test was conducted to compare mean choroidal thicknesses between symptomatic eyes and fellow eyes of patients.The datum between patients and normal subjects were analyzed by independent-samples t-test.Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed and the digital images were analyzed in CSC patients.Results The 21 CSC patients had a mean age of 45.6 years,and 12 patients (57.1％) were male.The choroid in symptomatic eyes was thickest beneath the fovea (519.0 ± 102.5) μm.It was significantly thicker than that in the fellow eyes (439.3 ± 94.1) μm (t =4.171,P ＜ 0.05).Choroidal thickness in both groups was significantly greater than that in the eyes of age-and sex-matched normal subjects (332.0 ± 67.3) μm (t =7.125,4.441 ;P ＜0.05).Choroidal thickness at each of the other 12 points showed a similar tendency (t =2.544 to 3.819,4.799 to 7.816,2.487 to 5.236;P ＜0.05).ICGA showed a choroidal filling delay (100％),vessels dilation (90.5％),and focal choroidal hyperfluorescence (100％) surrounding leakage from the RPE in symptomatic eyes.Pigment epithelium detachment with abnormal choroidal circulation was observed in 6 fellow eyes.In 4 symptomatic eyes and 11 fellow eyes,ICGA revealed choroidal hyperfluorescence but FFA showed normal appearance.Conclusions CSC seems to be a bilateral eye disease with choroidal focal ischemia followed by vessels congestion and hyperpermeability.EDI OCT is a useful tool for monitoring choroidal thickness changes caused by choroidal vascular hyperpermeability.
