Li Lüe, Li Dong-hui, Yang Zhi-kun, Bian Ai-ling, Chen You-xin, Dong Fang-tian
Department of Ophthalmology, Chinese Academy of Medical Sciences, Beijing, China.
Zhonghua Yan Ke Za Zhi. 2012 Oct;48(10):878-82.
To evaluate the characteristics of choroidal thickness changes and abnormalities in choroidal circulation in cases of central serous chorioretinopathy (CSC).
This was a case control study, we measured the bilateral choroidal thickness in 21 patients with unilateral CSC and 24 eyes of 24 age- and sex-matched normal subjects using enhanced depth imaging optical coherence tomography (EDI-OCT). The choroid was measured from the posterior edge of the retinal pigment epithelium (RPE) to the choroid-scleral junction at 500 µm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Paired-samples t-test was conducted to compare mean choroidal thicknesses between symptomatic eyes and fellow eyes of patients. The datum between patients and normal subjects were analyzed by independent-samples t-test. Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed and the digital images were analyzed in CSC patients.
The 21 CSC patients had a mean age of 45.6 years, and 12 patients (57.1%) were male. The choroid in symptomatic eyes was thickest beneath the fovea (519.0 ± 102.5) µm. It was significantly thicker than that in the fellow eyes (439.3 ± 94.1) µm (t = 4.171, P < 0.05). Choroidal thickness in both groups was significantly greater than that in the eyes of age- and sex-matched normal subjects (332.0 ± 67.3) µm (t = 7.125, 4.441; P < 0.05). Choroidal thickness at each of the other 12 points showed a similar tendency (t = 2.544 to 3.819, 4.799 to 7.816, 2.487 to 5.236; P < 0.05). ICGA showed a choroidal filling delay (100%), vessels dilation (90.5%), and focal choroidal hyperfluorescence (100%) surrounding leakage from the RPE in symptomatic eyes. Pigment epithelium detachment with abnormal choroidal circulation was observed in 6 fellow eyes. In 4 symptomatic eyes and 11 fellow eyes, ICGA revealed choroidal hyperfluorescence but FFA showed normal appearance.
CSC seems to be a bilateral eye disease with choroidal focal ischemia followed by vessels congestion and hyperpermeability. EDI OCT is a useful tool for monitoring choroidal thickness changes caused by choroidal vascular hyperpermeability.
评估中心性浆液性脉络膜视网膜病变（CSC）患者脉络膜厚度变化特征及脉络膜循环异常情况。
这是一项病例对照研究，我们使用增强深度成像光学相干断层扫描（EDI - OCT）测量了21例单侧CSC患者的双侧脉络膜厚度以及24名年龄和性别匹配的正常受试者的24只眼睛。从视网膜色素上皮（RPE）后缘至脉络膜 - 巩膜交界处，在从黄斑颞侧3 mm至黄斑鼻侧3 mm的水平截面以500 µm间隔测量脉络膜。采用配对样本t检验比较患者患眼与对侧眼的平均脉络膜厚度。采用独立样本t检验分析患者与正常受试者的数据。对CSC患者进行眼底荧光血管造影（FFA）和吲哚菁绿血管造影（ICGA），并对数字图像进行分析。
21例CSC患者的平均年龄为45.6岁，12例（57.1%）为男性。患眼脉络膜在黄斑下方最厚（519.0±102.5）µm，明显厚于对侧眼（439.3±94.1）µm（t = 4.171，P < 0.05）。两组脉络膜厚度均显著大于年龄和性别匹配的正常受试者眼睛的脉络膜厚度（332.0±67.3）µm（t = 7.125，4.441；P < 0.05）。其他12个点处的脉络膜厚度也显示出类似趋势（t = 2.544至3.819，4.799至7.816，2.487至5.236；P < 0.05）。ICGA显示患眼脉络膜充盈延迟（100%）、血管扩张（90.5%）以及RPE渗漏周围的脉络膜局灶性高荧光（100%）。6只对侧眼中观察到色素上皮脱离伴脉络膜循环异常。在4只患眼和11只对侧眼中，ICGA显示脉络膜高荧光，但FFA显示外观正常。
CSC似乎是一种双侧眼病，伴有脉络膜局灶性缺血，随后出现血管充血和高通透性。EDI OCT是监测脉络膜血管高通透性引起的脉络膜厚度变化的有用工具。
