Hirami Yasuhiko, Tsujikawa Akitaka, Sasahara Manabu, Gotoh Norimoto, Tamura Hiroshi, Otani Atsushi, Mandai Michiko, Yoshimura Nagahisa
Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Clin Exp Ophthalmol. 2007 Apr;35(3):225-30. doi: 10.1111/j.1442-9071.2006.01447.x.
To examine with en face optical coherence tomography (OCT) the alterations of retinal pigment epithelium (RPE) in central serous chorioretinopathy (CSC) and their role in the pathophysiology of CSC.
We examined retrospectively 30 consecutive eyes of 30 patients with various phases of CSC. All patients underwent fluorescein angiography, indocyanine green angiography, and en face and longitudinal OCT examinations.
Of 25 eyes with acute CSC, en face OCT showed RPE abnormalities in 22 eyes (88%) with pigment epithelial detachment (PED) in nine eyes (36%) and a small bulge of RPE in the posterior pole in 15 eyes (60%). Of four eyes with chronic CSC, OCT showed PED in one eye (25%) and a small bulge of RPE in other three eyes (75%). Of 29 eyes with acute or chronic CSC, fluorescein angiography showed characteristic pinpoint leakage in 20 eyes (69%). Of these 20 eyes, a leaking point was located within PEDs in five eyes (25%) and was consistent with the bulge of RPE in nine eyes (45%). With indocyanine green angiography, 28 (97%) eyes showed choroidal vascular hyperpermeability. Ten of the 11 eyes with PED (91%) showed PED within the areas of choroidal vascular hyperpermeability. Sixteen of the 18 eyes with a bulge of RPE (89%) showed the bulge within areas of choroidal vascular hyperpermeability. The one eye in the quiescent CSC exhibited multiple small PEDs within the areas of choroidal vascular hyperpermeability by en face OCT.
En face OCT enables us to detect alterations of RPE in eyes with CSC. Most alterations of RPE were associated with choroidal abnormalities.
采用表面光学相干断层扫描（OCT）检查中心性浆液性脉络膜视网膜病变（CSC）患者视网膜色素上皮（RPE）的改变及其在CSC病理生理学中的作用。
我们回顾性检查了30例不同阶段CSC患者的30只连续眼。所有患者均接受了荧光素血管造影、吲哚菁绿血管造影以及表面和纵向OCT检查。
在25只急性CSC眼中，表面OCT显示22只眼（88%）存在RPE异常，其中9只眼（36%）有色素上皮脱离（PED），15只眼（60%）后极部RPE有小隆起。在4只慢性CSC眼中，OCT显示1只眼（25%）有PED，另外3只眼（75%）RPE有小隆起。在29只急性或慢性CSC眼中，荧光素血管造影显示20只眼（69%）有特征性的点状渗漏。在这20只眼中，5只眼（25%）的渗漏点位于PED内，9只眼（45%）的渗漏点与RPE隆起一致。吲哚菁绿血管造影显示，28只眼（97%）有脉络膜血管高通透性。11只PED眼中的10只眼（91%），其PED位于脉络膜血管高通透性区域内。18只RPE隆起眼中的16只眼（89%），其隆起位于脉络膜血管高通透性区域内。静止期CSC的1只眼经表面OCT检查显示，在脉络膜血管高通透性区域内有多个小PED。
表面OCT使我们能够检测CSC患者眼中RPE的改变。大多数RPE改变与脉络膜异常有关。
