Pang Claudine E, Shah Vinnie P, Sarraf David, Freund K Bailey
Vitreous, Retina, Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York.
Vitreous, Retina, Macula Consultants of New York, New York, New York; New York University School of Medicine, Department of Ophthalmology, New York, New York.
Am J Ophthalmol. 2014 Aug;158(2):362-371.e2. doi: 10.1016/j.ajo.2014.04.021. Epub 2014 May 1.
To describe the spectrum of ultra-widefield autofluorescence (AF) and indocyanine green (ICG) angiographic findings in central serous chorioretinopathy (CSC).
Retrospective observational case series.
In 37 patients, 65 eyes with CSC from 2 vitreoretinal clinical practices were imaged using ultra-widefield AF and 24 of these eyes with ultra-widefield ICG angiography. Images were correlated with clinical findings and spectral-domain optical coherence tomography (OCT).
In 37 (57%) eyes, a variety of altered AF patterns, including gravitational tracts, extended beyond the posterior 50 degrees of retina. Hyper-AF corresponded to areas of subretinal fluid (SRF) on spectral-domain OCT and was found to persist in 44 (70%) eyes for up to 8 years despite resolution of SRF. These areas corresponded to outer retinal atrophy with viable retinal pigment epithelium (RPE) on spectral-domain OCT and may be explained by the unmasking of normal background RPE AF. Ultra-widefield ICG angiography revealed dilated choroidal vessels and choroidal hyperpermeability in areas corresponding to altered AF on ultra-widefield AF in all 24 eyes. In 20 (83.3%) eyes, dilated vessels were observed in association with 1 or more congested vortex veins ampullas, suggesting that outflow congestion may be a contributing factor to the pathogenesis of CSC.
Ultra-widefield AF and ICG angiography in CSC revealed more widespread disease in a single image than with standard field imaging and may be useful for identifying peripheral areas of previous or ongoing SRF and choroidal hyperpermeability that can assist in the diagnosis of CSC, surveillance of recurrent disease and treatment of active disease.
描述中心性浆液性脉络膜视网膜病变（CSC）的超广角自发荧光（AF）和吲哚菁绿（ICG）血管造影表现谱。
回顾性观察病例系列。
对来自2个玻璃体视网膜临床实践的37例患者的65只CSC患眼进行超广角AF成像，其中24只眼进行超广角ICG血管造影。将图像与临床发现及光谱域光学相干断层扫描（OCT）结果相关联。
在37只（57%）眼中，多种改变的AF模式，包括重力性条纹，延伸至视网膜后50度以外。高AF对应于光谱域OCT上的视网膜下液（SRF）区域，并且发现在44只（70%）眼中SRF消退后该区域持续存在长达8年。这些区域在光谱域OCT上对应于具有存活视网膜色素上皮（RPE）的外层视网膜萎缩，可能是由于正常背景RPE AF的显露所致。超广角ICG血管造影显示，在所有24只眼中，与超广角AF上改变的AF区域相对应的区域出现脉络膜血管扩张和脉络膜高通透性。在20只（83.3%）眼中，观察到扩张的血管与1条或更多条充血的涡静脉壶腹相关，提示流出道充血可能是CSC发病机制的一个促成因素。
CSC的超广角AF和ICG血管造影在单幅图像中显示的病变范围比标准视野成像更广泛，可能有助于识别先前或正在存在的SRF及脉络膜高通透性的周边区域，从而辅助CSC的诊断、复发性疾病的监测及活动性疾病的治疗。
