CAJ | 학술논문

目的观察先天性局域性脉络膜发育不良的3D-OCT表现特征.方法回顾性分析11例(13眼)临床诊断为先天性局域性脉络膜发育不良患者的3D-OCT检查结果,结合眼底彩照重点分析该病在3D-OCT分层七的表现.结果先天性局域性脉络膜发育不良患者的3D-OCT有以下几个特点:①黄斑区色素上皮带及脉络膜带的弧度发生改变,出现切迹共有8例(9眼),切迹均位于中心凹的颢侧且在黄斑区的水平缝及其附近,断层显示切迹区对应的视网膜色素上皮(RPE)层存在明显的凹陷;②黄斑区视网膜色素上皮带出现连续性中断,其中1眼断层显示缺损区对应的RPE及脉络膜层存在明显的凹陷;③黄斑区色素上皮带和脉络膜带全层缺损,其中2眼表现为中心凹下色素上皮带及脉络膜带闭合不全,呈中空现象;④在色素上皮和脉络膜发育不全处脉络膜反射增高,有的病例显著增高,这是脉络膜结构发生纤维化改变所致.结论先天性局域性脉络膜发育不良患者都有不同程度的黄斑区色素上皮带、脉络膜带的弧度改变或RPE带的连续性中断及缺损,说明眼泡胚胎裂闭锁不够完善,当不合并其他异常时很难发现.因此,对于临床上一些视力不能矫正且无确切弱视诱因的"弱视"患者,建议常规作3D-OCT检查,可能会发现一些亚临床的局域性脉络膜发育不良.
목적 관찰선천성국역성맥락막발육불량적3D-OCT표현특정.방법 회고성분석11례(13안)림상진단위선천성국역성맥락막발육불량환자적3D-OCT검사결과,결합안저채조중점분석해병재3D-OCT분층칠적표현.결과 선천성국역성맥락막발육불량환자적3D-OCT유이하궤개특점:①황반구색소상피대급맥락막대적호도발생개변,출현절적공유8례(9안),절적균위우중심요적호측차재황반구적수평봉급기부근,단층현시절적구대응적시망막색소상피(RPE)층존재명현적요함;②황반구시망막색소상피대출현련속성중단,기중1안단층현시결손구대응적RPE급맥락막층존재명현적요함;③황반구색소상피대화맥락막대전층결손,기중2안표현위중심요하색소상피대급맥락막대폐합불전,정중공현상;④재색소상피화맥락막발육불전처맥락막반사증고,유적병례현저증고,저시맥락막결구발생섬유화개변소치.결론 선천성국역성맥락막발육불량환자도유불동정도적황반구색소상피대、맥락막대적호도개변혹RPE대적련속성중단급결손,설명안포배태렬폐쇄불구완선,당불합병기타이상시흔난발현.인차,대우림상상일사시력불능교정차무학절약시유인적"약시"환자,건의상규작3D-OCT검사,가능회발현일사아림상적국역성맥락막발육불량.
Objective To observe the characteristics of three-dimensional optical coherence tomography (3D-OCT) in congenital zonal choroidal dystrophy (CZCD) patients. Methods 3D-OCT data from 11 patients (13 eyes) who were diagnosed with CZCD was retrospectively analyzed and combined with fundus photography. Results The characteristics of 3D-OCT in CZCD patients were as follows: ①The reflex curve changes of the retinal pigment epithelium (RPE) and choroid band as well as the notch were observed in 9 eyes of 8 patients. And the notches were all located on the temporal side of the fovea. The separated layer of the retina revealed by 3D-OCT showed that there was an obvious concavity of the RPE corresponding to the notch. ②RPE was discontinuous in 1 eye. The separated layer of the retina revealed by 3D -OCT showed that there was an obvious corresponding concavity in the RPE and choroid band. ③The RPE and choroid band were absent in the macular area in 2 eyes. There was a hollow in the RPE and choroid band under the fovea. ④A higher reflex was observed in the choroid where the RPE and choroid band had dystrophy. This is the result of the fibration of the choroid structure. Conclusion There are different degrees of change in the RPE and choroid membrane of the macular area. These changes include a change in the reflex curve, a discontinuity of the RPE and the absence of the RPE. All of this is the result of an anormaly of the embryonic fissure. It is difficult to discover where there is no complication. Therefore, we suggest that 3D-OCT should be performed routinely when a patient's visual acuity is not normal even if there is no evidence of eye disease. It may be diagnosed as CZCD by 3D-OCT.