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多灶性脉络膜血管病和中心性浆液性脉络膜视网膜病变中感光细胞层的厚度。

Thickness of photoreceptor layers in polypoidal choroidal vasculopathy and central serous chorioretinopathy.

机构信息

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2010 Aug;248(8):1077-86. doi: 10.1007/s00417-010-1338-5. Epub 2010 Mar 13.

Abstract

BACKGROUND

To evaluate retinal thickness using spectral-domain optical coherence tomography (SD-OCT) with reduced speckle noise in eyes with polypoidal choroidal vasculopathy (PCV) compared to those with normal eyes and those with central serous chorioretinopathy (CSC).

METHODS

We retrospectively reviewed cases of foveal serous retinal detachment in 36 eyes of 36 patients with active CSC and 23 eyes of 23 patients with active PCV, and 44 eyes of 44 normal subjects. Patients were examined using SD-OCT with reduced speckle noise, and the thickness of the outer nuclear layer (ONL), photoreceptor inner segment (IS), and photoreceptor outer segment (OS) were measured.

RESULTS

The ONL and IS were thicker in normal eyes than in eyes with CSC or PCV (P < 0.001). The OS was significantly less thick in eyes with PCV than in normal eyes (P < 0.001), whereas there was no significant difference between eyes with CSC and normal eyes. The thickness of IS and OS in eyes with PCV was related to fibrin or hemorrhage being present in the subretinal space. In eyes with PCV, best-corrected visual acuity at baseline correlated with IS thickness (P = 0.023).

CONCLUSIONS

Thinning of each photoreceptor layer was observed in the eyes of PCV patients as compared to that observed in the case of normal individuals. The differentiating factors between PCV and CSC, observed using SD-OCT, include the thinning of the OS in eyes with PCV, which makes SD-OCT helpful in differentiating PCV from CSC. More severe photoreceptor alterations were seen in PCV, because fibrin and hemorrhage were present in the subretinal space, which correlated with poorer vision.

摘要

背景

与正常眼和中心性浆液性脉络膜视网膜病变(CSC)相比,利用具有低散斑噪声的谱域光相干断层扫描(SD-OCT)评估息肉样脉络膜血管病变(PCV)眼的视网膜厚度。

方法

我们回顾性分析了 36 例(36 只眼)活动性 CSC 和 23 例(23 只眼)活动性 PCV 患者以及 44 例(44 只眼)正常对照者的黄斑浆液性视网膜脱离病例。患者均接受具有低散斑噪声的 SD-OCT 检查,并测量外核层(ONL)、光感受器内节(IS)和光感受器外节(OS)的厚度。

结果

正常眼的 ONL 和 IS 比 CSC 或 PCV 眼厚(P<0.001)。PCV 眼的 OS 明显比正常眼薄(P<0.001),而 CSC 眼与正常眼之间无显著差异。PCV 眼的 IS 和 OS 厚度与视网膜下空间存在纤维蛋白或出血有关。在 PCV 眼中,基线时最佳矫正视力与 IS 厚度相关(P=0.023)。

结论

与正常个体相比,PCV 患者的每个光感受器层均变薄。SD-OCT 观察到的 PCV 和 CSC 的鉴别因素包括 PCV 眼中 OS 的变薄,这使得 SD-OCT 有助于区分 PCV 和 CSC。PCV 中更严重的光感受器改变是因为视网膜下空间存在纤维蛋白和出血,这与视力较差有关。

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