急性中心性浆液性脉络膜视网膜病变患眼光相干断层扫描血管成像观察

摘要

Objective To observe the alterations of vascular density of superficial or deep retinal vascular plexus and the area of foveal avascular zone (FAZ) in acute central serous chorioretinopathy (CSC) eyes. Methods This is a retrospective study including 22 patients with unilateral CSC in acute stages. The patients were divided into group A (22 affected eyes) and B (22 fellow eyes). Twenty eyes of 20 age and gender-matched healthy volunteers (group C) were enrolled in this study. All subjects underwent optical coherence tomography (OCT) angiography examinations. The observation index included signal intensity of blood flow in choroidal capillary, vessel density and FAZ on the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Results The FAZ on DCP in group A was larger than that in group B and C (t=4.28, 5.57; P=0.00、0.00), but there was no significant difference of FAZ on SCP among 3 groups (t=0.28, 0.80; P=0.78, 0.43). The vessel density of SCP and DCP in group A and B were decreased than those in group C (t=-4.40, -2.91; P=0.00, 0.00). The type of choroidal capillaries dilation had two different manifestations by OCTA, which was circumscribed in 12 eyes and diffuse in 10 eyes. The subretinal fluid in macular area which presented dark chamber with weak reflection was observed by en-face OCT. Conclusions The vessel density of SCP and DCP in both eyes of acute CSC are lower than those in normal eyes. The FAZ of DCP in affected eyes of acute CSC is larger than that in fellow eyes and normal eyes. The blood flow of dilated choroidal capillary can be manifested as different morphological enhancements.%目的 观察急性中心性浆液性脉络膜视网膜病变(CSC)患眼视网膜浅层及深层毛细血管血流密度和黄斑中心凹无血管区面积(FAZ)的变化,以及脉络膜毛细血管血流增强的形态.方法 回顾性病例研究.临床检查确诊的单眼急性CSC患者22例(病例组)纳入研究.将病例组患者的患眼、对侧眼分别设为A、B组,均为22只眼.选取年龄匹配的正常人20名20只眼作为正常对照组(C组).采用光相干断层扫描(OCT)血管成像(OCTA)测量所有受检眼的视网膜浅层毛细血管丛(SCP)及深层毛细血管丛(DCP)的FAZ及血流密度,并观察患眼脉络膜毛细血管血流信号强度.采用配对t检验比较3组受检眼之间FAZ和血流密度的差异.结果 与B、C组受检眼比较,A组患眼DCP的FAZ扩大,差异有统计学意义(t=4.28、5.57,P=0.00、0.00);SCP的FAZ差异无统计学意义(t=0.28、0.80,P=0.78、0.43).A、B组受检眼SCP、DCP的血流密度均较C组受检眼明显下降,差异有统计学意义(t=-4.40、-2.91,P=0.00、0.00).OCTA检查显示,A组患眼脉络膜毛细血管表现为局灶性血流增强者12只眼;弥漫性血流增强者10只眼.平面OCT可见呈弱反射暗腔的黄斑区视网膜下积液面积.结论 单眼急性CSC患者双眼SCP、DCP的血流密度较正常眼均降低,患眼DCP的FAZ较对侧眼及正常眼扩大;扩张的脉络膜毛细血管血流可表现为不同形态增强.