[1]肖艳辉,刘高勤,夏蔚.慢性中心性浆液性脉络膜视网膜病变与息肉样脉络膜血管病变多模式影像学特征的比较[J].眼科新进展,2020,40(12):1139-1142.[doi:10.13389/j.cnki.rao.2020.0253]
　XIAO Yanhui,LIU Gaoqin,XIA Wei.Multimodal imaging comparison of chronic central serous chorioretinopathy and polypoidal choroidal vasculopathy[J].Recent Advances in Ophthalmology,2020,40(12):1139-1142.[doi:10.13389/j.cnki.rao.2020.0253]
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慢性中心性浆液性脉络膜视网膜病变与息肉样脉络膜血管病变多模式影像学特征的比较/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年12期
页码:
1139-1142
栏目:
应用研究
出版日期:
2020-12-05

文章信息/Info

Title:
Multimodal imaging comparison of chronic central serous chorioretinopathy and polypoidal choroidal vasculopathy
文章编号:
1139
作者:
肖艳辉; 刘高勤; 夏蔚
215006　江苏省苏州市，苏州大学附属第一医院眼科
Author(s):
XIAO Yanhui; LIU Gaoqin; XIA Wei
Department of Ophthalmology,the First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu Province,China
关键词:
慢性中心性浆液性脉络膜视网膜病变; 息肉样脉络膜血管病变; 脉络膜新生血管; 光学相干断层扫描血管成像; 多模式影像检查
Keywords:
chronic central serous chorioretinopathy;  polypoidal choroidal vasculopathy;  choroidal neovascularization;  optical coherence tomography angiography;  multimodal imaging
分类号:
R774
DOI:
10.13389/j.cnki.rao.2020.0253
文献标志码:
A
摘要:
目的　比较慢性中心性浆液性脉络膜视网膜病变（chronic central serous chorioretinopathy,CCSC）与息肉样脉络膜血管病变（polypoidal choroidal vasculopathy,PCV）的多模式影像学差异。方法　回顾性分析CCSC组11例11眼患者及PCV组21例21眼患者的临床资料。所有患者均行最佳矫正视力、黄斑中心凹下脉络膜厚度测量及荧光素眼底血管造影、吲哚菁绿血管造影、光学相干断层扫描血管成像（optical coherence tomography angiography,OCTA）和频域光学相干断层扫描多模式影像学检查，并对检查结果进行统计学分析。结果　CCSC组患者最佳矫正视力为0.33±0.11，显著高于PCV组（0.21±0.13），差异有统计学意义（P<0.05）。CCSC组患者黄斑中心凹下脉络膜厚度为（368.20±51.65）μm，PCV组为（342.28±37.18）μm，两组相比差异无统计学意义（P>0.05）。荧光素眼底血管造影检查结果显示，CCSC组和PCV组均为斑点状高荧光表现，CCSC组患眼可伴有色素上皮萎缩带或慢性神经上皮脱离通道表现。吲哚菁绿血管造影检查结果显示，CCSC组11眼病灶区出现周围脉络膜血管扩张及高通透性改变；而PCV组21眼均出现脉络膜息肉样病变，其中12眼为脉络膜分支血管网。OCTA检查结果显示，CCSC组4眼病灶部位表现为脉络膜毛细血管层高血流信号，其外环绕低血流信号，7眼表现为粗颗粒形态的斑驳状血流信号；PCV组15眼可检出息肉样病变，表现为高反射信号，呈结节状、环状或点状，12眼检出脉络膜分支血管网病变，表现为血管样结构的高血流信号。频域光学相干断层扫描检查发现，CCSC组7眼为浆液性视网膜色素上皮脱离（pigment epithelium detachment，PED）；PCV组12眼为波浪形隆起的视网膜色素上皮层与Bruch膜组成的双层征，10眼为陡峭的视网膜色素上皮指状突起（或称PED峰），18眼为浆液性或出血性PED。CCSC组患者治疗随访时，OCTA检查发现2眼继发I型脉络膜新生血管。结论　CCSC与PCV之间存在不同的影像学表现，多模式影像检查有助于两者的鉴别。另外，OCTA能够较好地显示脉络膜新生血管结构，可用于该类疾病的治疗随访。
Abstract:
Objective　To compare the multimodal imaging characteristics of chronic central serous chorioretinopathy (CCSC) and polypoidal choroidal vasculopathy (PCV).Methods　A retrospective analysis was performed, including data of 11 eyes from 11 patients in CCSC group and 21 eyes from 21 patients in PCV group. The best corrected visual acuity and subfoveal choroidal thickness were examined. All patients underwent multimodal imaging examinations, including fundus fluorescein angiography, indocyanine green angiography, optical coherence tomography angiography (OCTA) and spectral-domain optical coherence tomography.Results　The best corrected visual acuity in CCSC group was 0.33±0.11, which was significantly higher compared to that in PCV group (0.21±0.13) (P＜0.05). The subfoveal choroidal thicknesses in CCSC group and PCV group were (368.20±51.65) μm and (342.28±37.18) μm, respectively, and there was no significant difference between two groups (P＞0.05). Both in CCSC group and PCV group, fundus fluorescein angiography showed multifocal hyperfluorescence, while retinal pigment epithelial cell atrophy or chronic neuroepithelial detachment pathway was shown in CCSC group. Indocyanine green angiography detected dilated choroidal vessel and hyper fluorescence in 11 eyes in CCSC group, while polyps in 21 eyes and branch vessels network in 12 eyes in PCV group. OCTA imaging detected central high-flow signal surrounded by outer low-flow signal in 4 eyes and mottled flow signal in 7 eyes in choroidal capillary layer in CCSC group, while polyps appeared as nodular，ring or spot signal in 15 eyes and branch vessels network that appeared as vascular structure hyper flow signal in 12 eyes in PCV group. Spectral-domain optical coherence tomography revealed serous pigment epithelium detachment (PED) in 7 eyes in CCSC group, while double layer sign that was wavy elevation of the retinal pigment epithelium from the underlying Bruch’s membrane was observed in 12 eyes, sharp pigment epithelial detachment (or PED peak) in 10 eyes, and serous or hemorrhagic PED in 18 eyes in PCV group. In follow-up, OCTA detected type I choroidal neovascularization secondary to CCSC in 2 eyes.Conclusion　Imaging characteristics of CCSC and PCV are different, and multimodal imaging is helpful to the diagnosis of CCSC and PCV. Moreover, OCTA can effectively reveal choroidal neovascularization, so it has definite application value in follow-up.

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备注/Memo

备注/Memo:
国家自然科学基金资助（编号：81970830）
更新日期/Last Update: 2020-12-05