CAJ | 학술논문

目的观察中心性浆液性脉络膜视网膜病变(CSC)患眼光感受器层的频域光学相干断层扫描(Spectralis OCT)的图像特征,研究CSC患眼光感受器外节带形态及外核层厚度与最佳矫正视力(BCVA)的关系.方法前瞻性病例对照研究.对23例(24眼)CSC患者及18例(18眼)正常对照者的黄斑部进行Spectralis OCT检查,观察CSC患眼光感受器层的形态特征;测量两组中心凹外核层的厚度(CTONL).根据外节带的形态将CSC组分成光感受器外节保存型和外节萎缩型,比较各类型问CTONL以及BCVA的差异,并分析CSC患眼CTONL和BCVA的关系.各组间CTONL、BCVA的比较采用独立样本t检验:CSC组BCVA与CTONL的关系采用Pearson相关分析:CSC组病程与BCVA以及CTONL的关系采用Spearman秩相关分析.结果 24只CSC眼Spectralis OCT示,17眼(71%)为光感受器外节保存型,7眼(29%)为外节萎缩型.对照眼和CSC眼CTONL分别为(114.8±15.6)μm和(73.6±19.6)μm,两组间差异有统计学意义(t=7.274,P<0.01).其中,CSC组中外节保存型、外节萎缩型的CTONL分别为(82.1±14.6)μm和(53.0±14.1)μm,两组间差异有统计学意义(t=4.482,P<0.01).CSC组中外节保存型和外节萎缩型的BCVA分别为4.86±0.14和4.50±0.26,两组间差异有统计学意义(t=4.294,P<0.01).CSC组的BCVA与CTONL呈正相关(r=0.918,P<0.01).CSC患眼的病程与CTONL、BCVA均呈负相关(r=-0.994、-0.989,P<0.01).结论 CSC眼BCVA与光感受器CTONL及外节带的形态有关,外节保存型的BCVA明显好于外节萎缩型,外核层越薄,外节萎缩越多,BCVA越差.光感受器层的精细观察对视力预后的评估有一定的临床意义.
목적 관찰중심성장액성맥락막시망막병변(CSC)환안광감수기층적빈역광학상간단층소묘(Spectralis OCT)적도상특정,연구CSC환안광감수기외절대형태급외핵층후도여최가교정시력(BCVA)적관계.방법 전첨성병례대조연구.대23례(24안)CSC환자급18례(18안)정상대조자적황반부진행Spectralis OCT검사,관찰CSC환안광감수기층적형태특정;측량량조중심요외핵층적후도(CTONL).근거외절대적형태장CSC조분성광감수기외절보존형화외절위축형,비교각류형문CTONL이급BCVA적차이,병분석CSC환안CTONL화BCVA적관계.각조간CTONL、BCVA적비교채용독립양본t검험:CSC조BCVA여CTONL적관계채용Pearson상관분석:CSC조병정여BCVA이급CTONL적관계채용Spearman질상관분석.결과 24지CSC안Spectralis OCT시,17안(71%)위광감수기외절보존형,7안(29%)위외절위축형.대조안화CSC안CTONL분별위(114.8±15.6)μm화(73.6±19.6)μm,량조간차이유통계학의의(t=7.274,P<0.01).기중,CSC조중외절보존형、외절위축형적CTONL분별위(82.1±14.6)μm화(53.0±14.1)μm,량조간차이유통계학의의(t=4.482,P<0.01).CSC조중외절보존형화외절위축형적BCVA분별위4.86±0.14화4.50±0.26,량조간차이유통계학의의(t=4.294,P<0.01).CSC조적BCVA여CTONL정정상관(r=0.918,P<0.01).CSC환안적병정여CTONL、BCVA균정부상관(r=-0.994、-0.989,P<0.01).결론 CSC안BCVA여광감수기CTONL급외절대적형태유관,외절보존형적BCVA명현호우외절위축형,외핵층월박,외절위축월다,BCVA월차.광감수기층적정세관찰대시력예후적평고유일정적림상의의.
Objective To observe the features of the foveal photoreceptor layer in eyes with central serous chorioretinopathy (CSC) using spectral-domain optical coherence tomography (Spectralis OCT); to analyze the relationship between best corrected visual acuity (BCVA), the morphology of the outer segments (OS) and the thickness of the outer nuclear layer. Methods This was a prospective case control study. The morphology of the outer segments was observed and central thickness of outer nuclear layer (CTONL) at the central fovea was measured in 24 consecutive CSC eyes of 23 patients and 18 normal control eyes of 18 normal people on Spectralis OCT images. The eyes of CSC patients were divided into two groups based on the morphology of the outer segment: the preserved outer segement group and the atrophy group. The correlation between BCVA and CTONL in these groups was evaluated separately. An independent samples t test was used to compare CTONL and the average BCVA of the goups. A Pearson correlation test was used for the correlation between CTONL and BCVA in the CSC patient group. A Spearman rank correlation test was used for the correlation between symptom duration and CTONL in the CSC patient group. Results The outer segment band of the serous detached fovea was preserved well in 17 eyes (71%), and atrophic in 7 eyes (29%). The average CTONL was (73.6±19.6) μm in the CSC group, which was significantly less than that [(114.8±15.6)μm] in the normal group (t=7.274, P<0.01). The average CTONL was (53.0±14.1)μm in the atrophic subgroup, which was significantly thinner than that [(82.1±14.6)μm] in the preserved group (t =4.482, P<0.01). The BCVA was 4.86±0.14 in the atrophic group, which was significantly less than that (4.50±0.26) in the preserved group (t=4.294, P<0.01). BCVA was positively correlated with CTONL (r=0.918, P<0.01). The course of the disease was negatively correlated with CTONL and BCVA (r=-0.994,-0.989, P<0.01 for both). Conclusion BCVA is correlated with CTONL and the health of the outer segment, the BCVA of the preserved group is better than that of the atrophic group; the thinner the CTONL is, the worse the BCVA.