中心性浆液性脉络膜视网膜病变眼底红外线和自发荧光的影像特征
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Image characteristics of infrared ray and autofluorescence in central serous chorioretinopathy
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    目的:观察中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的眼底红外线(infrared ray,IR)和自发荧光(autofluorescence,AF)的影像特征。方法:采用Spectralis HRA海德堡共焦激光扫描系统的IR模式和AF模式,对76例80眼CSC患者进行IR眼底照相、AF眼底照相、荧光素眼底血管造影(FFA)检查。结果:患者80眼中,CSC病灶的IR影像:黄斑水肿区色暗,浆液性感光视网膜脱离边界清楚,可见白色斑点状病灶,尤其是对应于荧光造影时的渗漏部位。CSC病灶AF表现为黄斑区盘状的弱AF者18例18眼,占22.50%;黄斑区弱AF中包含较多点状强AF者13例13眼,占16.25%;黄斑区弱AF中包含弥漫性强AF者11例11眼,占13.75%;黄斑盘状脱离区边缘强AF环者3例3眼,占3.75%;弱AF和斑点状强AF相连的复合病灶者19例21眼,占26.25%;后极部局灶性密集强AF和低AF者3例3眼,占3.75%;黄斑区弱AF中散在点片状低或强AF者9例11眼,占13.75%。FFA荧光素渗漏点或异常荧光与异常AF相对应者45例47眼,占58.75%;不一致者31例33眼,占41.25%。眼底红外像IR与FFA荧光素渗漏点相一致者65例68眼,占85.00%;不一致者11例12眼,占15.00%。结论:IR,AF检测为CSC的诊断提供了一个新的、快速、非创性检查手段,结合FFA检查,可以对CSC影像观察起到相互补充的作用。

    Abstract:

    ·AIM:To observe the image characteristics of infrared ray(IR)and autofluorescence(AF)in central serous chorioretinopathy(CSC).METHODS:Totally 80 eyes of 76 CSC patients were examined the infrared photography of ocular fundus,autofluorescence photography of ocular fundus,fundus fluorescein angiography(FFA)using IR imaging mode and FA imaging mode of Heidelberg Spectralis HRA.RESULTS:In 80 eyes,the IR image of CSC focus contained dark macular edema area,clear periphery in the macula layer detachment area,white spot-like focus existed specifically in the leaking area.The AF image of CSC focus showed patterns characterized as weak plate-like AF in the macular edema area(18 eyes of 18 patients,22.50%),weak AF with strong spot-like AF in the macular edema area(13 eyes of 13 patients,16.25%),weak AF with strong lamellar AF in the macular edema area(11 eyes of 11 patients,13.75%),strong AF circle in the periphery of macula layer detachment area(3 eyes of 3 patients,3.75%),weak AF combined with strong spot-like AF(21 eyes of 19 patients,26.25%),local densed strong AF and weak AF at the posterior pole(3 eyes of 3 patients,3.75%),weak AF in the macular edema area with weak or strong spot-like or plate-like AF scattered(11 eyes,13.75%).FFA fluorescein leaking point or abnormal fluorescence were in accordance with abnormal AF in 47 eyes of 45 patients(58.75%),not in accordance in 33 eyes of 31 patients(41.25%).The IR image of ocular fundus was in accordance with FFA fluorescein leaking point in 68 eyes of 65 patients(85.00%),not in accordance in 12 eyes of 11 patients(15.00%).CONCLUSION:IR and AF provide a novel,fast and non-surgical method for the diagnosis of CSC.IR and AF as complement are combined with FFA for the diagnosis of CSC.

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章淑华.中心性浆液性脉络膜视网膜病变眼底红外线和自发荧光的影像特征.国际眼科杂志, 2011,11(3):488-491.

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