Shukla D, Aiello L P, Kolluru C, Baddela S, Jager R D, Kim R
Retina-Vitreous Service, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India.
Eye (Lond). 2008 Apr;22(4):592-6. doi: 10.1038/sj.eye.6702818. Epub 2007 Apr 20.
To investigate the anatomic basis of atypical angiographic leaks in central serous chorioretinopathy (CSC) with optical coherence tomography (OCT).
Fluorescein angiography (FA) and OCT were performed in three eyes of three patients (two men, one woman) with CSC. The angiographic leaks were treated with transpupillary thermotherapy (TTT) in two patients with long-standing CSC. The investigations were repeated in the treated patients during follow-up visits.
Clinically, all patients demonstrated typical CSC; the female patient had subretinal fibrin under the detachment. FA showed unusual leakage patterns and OCT revealed bridging tissue connecting the pigment epithelial detachment (PED) to the overlying detached retina in all patients. CSC resolved completely in the two patients who underwent TTT along with normalization of the OCT findings. In one patient re-evaluated before complete resolution of CSC, OCT showed a flattened PED with disappearance of the bridging tissue and persistent serous detachment. FA demonstrated conversion of the previously atypical leak into a classic 'smokestack' configuration. Over the next month, leakage resolved completely. CSC and the anatomical findings persisted in the untreated patient.
OCT identified a potential anatomic basis for unusual angiographic leakage pattern in all three cases of CSC evaluated.
利用光学相干断层扫描（OCT）研究中心性浆液性脉络膜视网膜病变（CSC）中非典型血管造影渗漏的解剖学基础。
对3例（2例男性，1例女性）CSC患者的3只眼进行荧光素血管造影（FA）和OCT检查。2例患有长期CSC的患者采用经瞳孔温热疗法（TTT）治疗血管造影渗漏。在随访期间对接受治疗的患者重复进行检查。
临床上，所有患者均表现为典型的CSC；女性患者在视网膜脱离下方有视网膜下纤维蛋白。FA显示出异常的渗漏模式，OCT显示所有患者中均有连接色素上皮脱离（PED）与上方脱离视网膜的桥接组织。接受TTT治疗的2例患者CSC完全消退，OCT检查结果恢复正常。在1例CSC完全消退前重新评估的患者中，OCT显示PED变平，桥接组织消失，浆液性脱离持续存在。FA显示先前的非典型渗漏转变为典型的“烟囱”形态。在接下来的一个月里，渗漏完全消退。未治疗的患者CSC和解剖学表现持续存在。
在所有3例接受评估的CSC病例中，OCT均发现了非典型血管造影渗漏模式的潜在解剖学基础。
