Iida T, Hagimura N, Sato T, Kishi S
Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Japan.
Am J Ophthalmol. 2000 Jan;129(1):16-20. doi: 10.1016/s0002-9394(99)00272-x.
To evaluate central serous chorioretinopathy with optical coherence tomography during the acute phase and after resolution of the acute phase.
In a prospective study, 23 consecutive eyes of 23 patients (19 men, four women; mean age +/- SD, 46.0+/-8.1 years; range, 29 to 60 years) with central serous chorioretinopathy were examined with optical coherence tomography during the acute phase and after resolution of the retinal detachment. After the initial examination, the patients were reexamined for 3 to 6 months (mean, 4.7+/-1.1 months). Cross-sectional retinal images through the center of the fovea were obtained from all eyes by optical coherence tomography. The retinal thickness at the center of the fovea was measured. The difference between the retinal thickness during the acute phase and after resolution of the retinal detachment was statistically analyzed using the Wilcoxon test. We also examined a grayish-white lesion that corresponded to the leakage point in fluorescein angiography in four eyes.
In the acute phase, neurosensory retina was thickened within the area of serous retinal detachment in all 23 eyes. The detached retina was thicker than the reattached retina after resolution of the retinal detachment in all eyes. The retinal thickness at the center of the fovea during the acute phase (range, 157 to 236 microm; mean +/- SD, 196.9+/-22.6 microm) was significantly thickened compared with that after resolution (range, 105 to 152 microm; mean +/- SD, 124.8+/-10.7 microm; P<.0001, Wilcoxon test). In the acute phase, areas of low reflectivity localized within the detached retina were observed in 18 of the 23 eyes. In the area of the grayish-white lesion, optical coherence tomography showed a moderately reflective mass bridging the detached neurosensory retina and retinal pigment epithelium in the four eyes; the outer layer of the detached retina was more highly reflective in these eyes. The retinal pigment epithelium was focally detached beneath the subretinal reflective mass in three of the four eyes.
In all eyes studied, neurosensory retina was thickened within the area of serous retinal detachment in the acute phase of central serous chorioretinopathy. The grayish-white lesion seems to be a fibrinous exudate that accumulates in the subretinal space and infiltrates into the outer retina.
利用光学相干断层扫描技术评估中心性浆液性脉络膜视网膜病变的急性期及急性期消退后的情况。
在一项前瞻性研究中，对23例中心性浆液性脉络膜视网膜病变患者（19例男性，4例女性；平均年龄±标准差，46.0±8.1岁；范围，29至60岁）的23只连续眼睛在急性期及视网膜脱离消退后进行光学相干断层扫描检查。初次检查后，对患者进行3至6个月（平均，4.7±1.1个月）的复查。通过光学相干断层扫描从所有眼睛获取穿过黄斑中心的视网膜横断面图像。测量黄斑中心的视网膜厚度。使用Wilcoxon检验对急性期与视网膜脱离消退后的视网膜厚度差异进行统计学分析。我们还检查了4只眼中与荧光素血管造影渗漏点相对应的灰白色病变。
在急性期，所有23只眼睛的浆液性视网膜脱离区域内神经感觉视网膜均增厚。所有眼睛中，视网膜脱离消退后脱离的视网膜比重新附着的视网膜更厚。急性期黄斑中心的视网膜厚度（范围，157至236微米；平均±标准差，196.9±22.6微米）与消退后相比显著增厚（范围，105至152微米；平均±标准差，124.8±10.7微米；P<0.0001，Wilcoxon检验）。在急性期，23只眼中有18只在脱离的视网膜内观察到低反射区域。在灰白色病变区域，光学相干断层扫描显示4只眼中有一个中等反射性团块连接脱离的神经感觉视网膜和视网膜色素上皮；这些眼中脱离视网膜的外层反射性更高。4只眼中有3只的视网膜色素上皮在视网膜下反射性团块下方局灶性脱离。
在所有研究的眼睛中，中心性浆液性脉络膜视网膜病变急性期浆液性视网膜脱离区域内神经感觉视网膜增厚。灰白色病变似乎是积聚在视网膜下间隙并浸润到外层视网膜的纤维蛋白渗出物。
