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中心性浆液性脉络膜视网膜病变消退后黄斑区光感受器外节的修复。

Restoration of outer segments of foveal photoreceptors after resolution of central serous chorioretinopathy.

机构信息

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.

出版信息

Jpn J Ophthalmol. 2010 Jan;54(1):55-60. doi: 10.1007/s10384-009-0766-4. Epub 2010 Feb 12.

Abstract

PURPOSE

To study morphologically and functionally the prognosis of damaged outer segments of the foveal photoreceptor layer in eyes with resolved central serous chorioretinopathy (CSC).

METHODS

We studied retrospectively the medical records of 70 patients (74 eyes) with resolved CSC. Optical coherence tomography was used to detect the junctions between inner and outer segments of the photoreceptors (IS/OS) as a hallmark of the integrity of the outer photoreceptor layer.

RESULTS

In 53 eyes (71.6%), the IS/OS line was clearly detected beneath the fovea immediately after resolution of the retinal detachment, with good visual acuity (VA). In the remaining 21 eyes (28.4%), however, the foveal IS/OS line could not be detected shortly after resolution of CSC, and VA was variable, ranging from 0.1 to 1.5 (median, 0.9). Of these 21 eyes, 15 had a follow-up examination with OCT, and in four the foveal IS/OS line was not detected at the follow-up and vision in these eyes remained poor. However, nine eyes showed recovery of the foveal IS/OS line during follow-up, and these eyes had substantial visual recovery.

CONCLUSIONS

Immediately after resolution of active CSC, although the IS/OS line cannot be detected beneath the fovea, it often shows restoration over time, with visual recovery, though in some eyes no restoration takes place and the prognosis remains poor.

摘要

目的

研究已消退的中心性浆液性脉络膜视网膜病变(CSC)患者中,受损的黄斑区光感受器外节形态和功能的预后。

方法

我们回顾性研究了 70 例(74 只眼)已消退的 CSC 患者的病历。使用光学相干断层扫描(OCT)来检测光感受器的内、外节(IS/OS)交界处,作为光感受器外节完整性的标志。

结果

在 53 只眼(71.6%)中,在视网膜脱离复位后,立即在黄斑下清晰地检测到 IS/OS 线,视力(VA)良好。然而,在其余 21 只眼(28.4%)中,CSC 复位后不久,黄斑区的 IS/OS 线无法检测到,VA 也各不相同,范围从 0.1 到 1.5(中位数,0.9)。在这 21 只眼中,有 15 只进行了 OCT 随访检查,其中 4 只在随访时未检测到黄斑区的 IS/OS 线,这些眼的视力仍然很差。然而,有 9 只眼在随访期间出现了黄斑区 IS/OS 线的恢复,这些眼的视力有了显著的恢复。

结论

尽管在 CSC 活动消退后立即无法在黄斑下检测到 IS/OS 线,但随着时间的推移,它通常会恢复,视力也会恢复,尽管在一些眼中没有恢复,预后仍然较差。

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