Wang Yao, Chen Zhi-Qing, Wang Wei, Fang Xiao-Yun
Eye Center, Second Affiliated Hospital, Medical College of Zhejiang University, Zhejiang Provincial Key Lab of Ophthalmology, Number 88 Jiefang Road, Hangzhou 310009, China.
J Ophthalmol. 2016;2016:7073083. doi: 10.1155/2016/7073083. Epub 2016 Jun 29.
Purpose. To investigate the prevalence and characteristics of focal choroidal excavation (FCE) concurrent with central serous chorioretinopathy (CSC) using multimodal imaging. Methods. This was a retrospective single-institution study. Clinical features and multimodal imaging findings were analyzed in eyes with CSC and FCEs, using imaging methods including optical coherence tomography (OCT), OCT angiography (OCTA), fluorescein angiography (FA), indocyanine green angiography (ICGA), fundus autofluorescence (FAF), and multispectral imaging. Results. Seventeen patients (4.8%) with 21 FCEs (19 eyes) were found among 351 consecutive Chinese patients with CSC. Chronic CSC represented 47.1% of those cases. Window defects in 12 lesions identified through FA and hypoautofluorescence in 13 lesions identified through FAF revealed retinal pigment epithelial attenuation. Choroidal hemodynamic disturbances characterized by localized filling defects at the excavation and circumferential hyperperfusion were validated by both ICGA and OCTA, which were similar to the angiographic features of normal chronic CSC. The hyperreflective tissue beneath FCE, observed on B-scan OCT, presented as intensive choroidal flow signals on OCTA. Conclusions. FCE is not uncommon in patients with CSC. Multimodal imaging suggested that the aberrant choroidal circulation might be a contribution factor for leakage from the dysfunctional retinal pigment epithelium at the area of excavation.
目的。使用多模态成像技术研究与中心性浆液性脉络膜视网膜病变（CSC）并发的局灶性脉络膜凹陷（FCE）的患病率和特征。方法。这是一项单机构回顾性研究。对患有CSC和FCE的眼睛的临床特征和多模态成像结果进行分析，采用的成像方法包括光学相干断层扫描（OCT）、OCT血管造影（OCTA）、荧光素血管造影（FA）、吲哚菁绿血管造影（ICGA）、眼底自发荧光（FAF）和多光谱成像。结果。在351例连续的中国CSC患者中发现了17例（4.8%）患有21个FCE（19只眼）的患者。慢性CSC占这些病例的47.1%。通过FA识别的12个病变中的窗样缺损以及通过FAF识别的13个病变中的低自发荧光显示视网膜色素上皮萎缩。ICGA和OCTA均证实了以凹陷处局部充盈缺损和周边高灌注为特征的脉络膜血流动力学紊乱，这与正常慢性CSC的血管造影特征相似。在B扫描OCT上观察到的FCE下方的高反射组织在OCTA上表现为密集的脉络膜血流信号。结论。FCE在CSC患者中并不少见。多模态成像表明，异常的脉络膜循环可能是挖掘区域功能失调的视网膜色素上皮渗漏的一个促成因素。
