Department of Ophthalmology, College of Medicine, Hanyang University, Seoul, Korea.
Am J Ophthalmol. 2012 Aug;154(2):366-375.e4. doi: 10.1016/j.ajo.2012.02.031. Epub 2012 May 23.
To investigate the time-period characteristics associated with morphologic changes in idiopathic central serous chorioretinopathy (CSC) using volume scans acquired by spectral-domain optical coherence tomography (SD-OCT).
Retrospective, observational, cross-sectional case series.
Patients underwent visual acuity measurements, fundus examinations, fluorescein angiography, indocyanine green angiography, and SD-OCT volume scans. Patients were classified into 5 categories-acute CSC, early chronic (EC) CSC, late chronic (LC) CSC, sequelae of CSC, or recurrent CSC-according to the chronicity and the recurrence. We investigated the relationship between our classification and the detailed morphologic changes of the retinal pigment epithelium and outer retina that were observed in the SD-OCT images.
A total of 76 eyes from 75 patients were included in this study. Serous retinal detachment was relatively higher in acute CSC. Low to flat pigment epithelial detachments (PEDs) were most commonly observed in all stages of CSC, especially in LC CSC, but some semicircular PEDs were occasionally observed in eyes with acute or EC CSC. Retinal dragging with fibrin was most frequently observed in eyes that were in the early stage of acute CSC. A thickened posterior surface of the detached retina was most commonly observed in eyes with acute CSC, whereas a thinned posterior surface of the detached retina was observed in eyes with LC CSC. Hyperreflective dots and subretinal exudates were more commonly observed in eyes with EC and LC CSC than in eyes with acute CSC. In eyes with recurrent CSC, 2 different patterns of SD-OCT findings were observed; these patterns resembled those that were found in either acute CSC or LC CSC.
SD-OCT finding patterns in CSC eyes differ according to the chronicity and the recurrence of the disease. Detailed investigation of the retinal pigment epithelium and outer retina using SD-OCT could be useful for estimating the duration of CSC.
使用谱域光相干断层扫描（SD-OCT）获得的容积扫描来研究特发性中心性浆液性脉络膜视网膜病变（CSC）的形态变化与时间的关系。
回顾性、观察性、横断面病例系列。
患者接受视力测量、眼底检查、荧光素血管造影、吲哚青绿血管造影和 SD-OCT 容积扫描。根据疾病的慢性程度和复发情况，将患者分为急性 CSC、早期慢性（EC）CSC、晚期慢性（LC）CSC、CSC 后遗症或复发性 CSC 五类。我们研究了我们的分类与 SD-OCT 图像中观察到的视网膜色素上皮和外视网膜的详细形态变化之间的关系。
本研究共纳入 75 例 76 只眼。急性 CSC 中，浆液性视网膜脱离相对较高。低平的色素上皮脱离（PED）在 CSC 的所有阶段都最常见，尤其是在 LC CSC 中，但在急性或 EC CSC 眼中偶尔也会观察到半圆形 PED。伴有纤维蛋白的视网膜牵拉在急性 CSC 的早期阶段最常见。急性 CSC 眼中最常见的是脱离视网膜的后表面增厚，而 LC CSC 眼中则是脱离视网膜的后表面变薄。EC 和 LC CSC 眼中比急性 CSC 眼中更常见高反射点和视网膜下渗出。复发性 CSC 眼中观察到两种不同的 SD-OCT 发现模式；这些模式类似于急性 CSC 或 LC CSC 中的发现。
CSC 眼中的 SD-OCT 发现模式因疾病的慢性程度和复发而不同。使用 SD-OCT 对视网膜色素上皮和外视网膜进行详细检查，有助于估计 CSC 的持续时间。
