目的 观察中心性浆液性脉络膜视网膜病变(CSC)神经上皮脱离区在频域光相干断层扫描(FD-OCT)的图像特征.方法 对采用国际标准视力表、裂隙灯显微镜、直接或间接检眼镜、荧光素眼底血管造影(FFA)和吲哚青绿血管造影(ICGA)检查确诊的黄斑部有神经上皮浆液性脱离的CSC患者88例92只眼进行FD-OCT检查.采用二极管反射的红外光对眼底黄斑中心部进行线性水平扫描,扫描深度2 mm,扫描面积6 mm× 6 mm,轴向分别率5 μm,横向分辨率18μm,扫描模式512×128.对比分析患者的FFA、ICGA检查资料,重点观察神经上皮脱离区域的FD-OCT图像特征. 结果所有患眼均有神经上皮的隆起与视网膜色素上皮(RPE)光带分离及脱离区内RPE光带的异常改变.其中,色素上皮脱离(PED)83只眼,占90.22%;RPE有结节状突起改变68只眼,占73.91%;PED灶有RPE局部缺损5只眼,占5.43%.神经上皮脱离腔内有细小尘状反光点36只眼,占39.14%.其中簇状分布17只眼(17.61%),柱状8只眼(8.69%),环形6只眼(6.52%),团块状5只眼(5.43%).神经上皮脱离区内有较多颗粒状强反光物质59只眼,占64.14%. 结论CSC的FD-OCT特征为RPE的光带分离及脱离区的RPE光带异常.FD-OCT能准确地发现CSC神经上皮脱离区内视网膜组织的各种细微形态学改变.%Objective To evaluate the morphological changes of retinal neuroepithelium of central serous chorioretinopathy (CSC) by Fourier-domain optical coherence tomography(FD-OCT). Methods FD-OCT scan was performed on 92 eyes of 88 patients with CSC. The CSC diagnosis was established by international visual acuity chart, slit-lamp microscope, direct/indirect ophthalmoscope, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA). 6 mm horizontal line OCT scan was performed utilizing the infrared light emitted by diode, the scan depth was 2 mm with a 6 mm × 6 mmtransverse area. The vertical and horizontal resolution was 5 μm and 18/.tin respectively. The scan mode was 512× 128. Results The uplift of retinal neuroepithelium, separation or abnormal band of retinal pigment epithelial (RPE) were found in all eyes. There were 83 eyes (90. 22%) of pigment epithelial detachment (PED), 68 eyes (73.91%) of nodular protruding of RPE, 5 eyes (5. 43%) of localized RPE defects in the PED lesion, 36 eyes (39.14%) of dust-like reflects in the subretinal space and 59 eyes (64. 14%) of granular deposits in the subretinal space. Conclusion Fourier-domain OCT scans can detect detailed morphologic changes in the retina of CSC patients.
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