中心性浆液性脉络膜视网膜病变眼底自发荧光影像的特点

摘要

AIM: To define the fundus autofluorescence ( FAF ) patterns in acute and chronic idiopathic central serous chorioretinopathy ( ICSCR ) and correlate them with fundus fluorescein angiography ( FFA) findings.METHODS:This is an observational case study in which we retrospectively reviewed the clinical data and FFA and FAF images of ICSCR patients and compared the findings.RESULTS: The study included 25 eyes of 17 patients. We detected acute ICSCR in 5 eyes, and chronic disease or recurrence in chronic disease in 20 eyes. FAF images in acute cases showed a sharply delineated hypoautofluorescent spot in exactly the same location as the pinpoint leak detected on fluorescein angiography. In FFA images of chronic ICSCR diffuse areas of RPE atrophy are visualized as transmission fluorescence. FAF images demonstrate hypo-autofluorescence that corresponds in shape and location to the areas showing the most intense transmission fluorescence on FFA, whereas areas with less transmission fluorescence on FFA correspond to hyper - autofluorescence on FAF. The hypo -autofluorescent spot pointing to the site of RPE leakage cannot be localized as precisely as in acute cases. CONCLUSION: FAF imaging in ICSCR is capable of depicting FAF patterns that are characteristic of various stages of the disease. It is a risk-free and reproducible alternative to fluorescein angiography in ICSCR.%目的：研究急性和慢性特发性中心性浆液性脉络膜视网膜病变眼底自发荧光影像模式及眼底荧光血管造影相关性发现。　　方法：观察性研究案例。回顾性分析中心性浆液性脉络膜视网膜病变患者临床数据，眼底荧光血管造影及眼底自发荧光影像，并对其调查结果进行比较。　　结果：该研究共纳入17例25眼。确诊为急性中心性浆液性脉络膜视网膜病变5眼，慢性疾病或复发性慢性疾病20眼。急性病例眼底自发荧光影像显示低荧光点与荧光血管造影检测出的荧光渗漏点位置相同。慢性特发性中心性浆液性脉络膜视网膜病变眼底荧光血管造影为视网膜色素上皮弥漫性萎缩区域，可透视荧光。眼底自发荧光影像的低荧光区域的形态和位置与眼底荧光血管造影的高荧光区域相对应，然而眼底荧光血管造影的低荧光区域与眼底自发荧光影像的高荧光区域相对应。在急性病例中，低自发荧光点不能准确指出视网膜色素上皮的渗漏点。　　结论：中心性浆液性脉络膜视网膜病变眼底自发荧光影像模式能够描述疾病不同阶段的特征，具有无风险和可再生性，可替代荧光素血管造影术治疗中心性浆液性脉络膜视网膜病变。