Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Retina. 2011 Mar;31(3):527-34. doi: 10.1097/IAE.0b013e3181eef2db.
To compare retinal morphologic alterations in eyes with polypoidal choroidal vasculopathy (PCV) and central serous chorioretinopathy (CSC) using speckle noise-reduced spectral-domain optical coherence tomography.
We retrospectively reviewed 63 eyes of 62 patients with active PCV and 38 eyes of 38 patients with active CSC. Patients underwent fundus photography, angiography, and speckle noise-reduced spectral-domain optical coherence tomography examinations, and retinal morphologic alterations were evaluated.
Cystoid macular edema, lipid deposits, subretinal hemorrhage, and hemorrhagic pigment epithelial detachment were not seen in any eye with CSC but were seen in eyes with PCV. In PCV, mean visual acuity was significantly poorer in eyes with fibrin infiltration (P = 0.027) or hemorrhagic infiltration (P = 0.002) in the fovea than in eyes without fibrin or hemorrhagic infiltration.
Differentiating factors between PCV and CSC noted on spectral-domain optical coherence tomography include a lack of cystoid macular edema, lipid deposition, subretinal hemorrhage, and hemorrhagic pigment epithelial detachment in eyes with CSC, which makes spectral-domain optical coherence tomography helpful in differentiating CSC from PCV. More severe retinal alterations were seen in PCV than in CSC because of infiltration of fibrin and hemorrhage in the outer retina, which also correlated with poorer vision.
利用斑点噪声减少的光谱域光学相干断层扫描比较息肉样脉络膜血管病变(PCV)和中心性浆液性脉络膜视网膜病变(CSC)眼中的视网膜形态改变。
我们回顾性分析了 62 例活动期 PCV 患者的 63 只眼和 38 例活动期 CSC 患者的 38 只眼。对患者进行眼底照相、血管造影和斑点噪声减少的光谱域光学相干断层扫描检查,并评估视网膜形态改变。
CSC 患者的眼中未见囊样黄斑水肿、脂质沉积、视网膜下出血和出血性色素上皮脱离,但在 PCV 患者的眼中可见。在 PCV 中,在黄斑区有纤维蛋白浸润(P=0.027)或出血性浸润(P=0.002)的眼中,视力明显比没有纤维蛋白或出血性浸润的眼中差(P=0.027)。
在光谱域光学相干断层扫描上,CSC 和 PCV 之间的鉴别因素包括 CSC 眼中缺乏囊样黄斑水肿、脂质沉积、视网膜下出血和出血性色素上皮脱离,这使得光谱域光学相干断层扫描有助于区分 CSC 和 PCV。由于外视网膜的纤维蛋白和出血浸润,PCV 中的视网膜改变比 CSC 更严重,这也与视力较差有关。