Cakir B, Reich M, Lang S J, Bühler A, Stahl A, Böhringer D, Agostini H, Lange C
Klinik für Augenheilkunde, Universitätsklinikum Freiburg.
Klin Monbl Augenheilkd. 2017 Sep;234(9):1161-1168. doi: 10.1055/s-0043-102576. Epub 2017 May 17.
Central serous chorioretinopathy (CSC) is a commonly acquired maculopathy characterized by the accumulation of subretinal fluid at the posterior pole. This study aims to analyze optical coherence tomography angiography (OCTA) findings in patients with acute and chronic CSC and to compare them to conventional imaging methods. A series of 43 consecutive eyes of 29 patients diagnosed with CSC and 18 eyes of 9 healthy control subjects were included in this retrospective study. The OCTA images were assessed and compared to conventional fluorescence (FAG) and indocyanine green angiography (ICG). All CSC patients demonstrated abnormal areas of focal hypo- and hyperperfusion in the choriocapillaris. These were particularly evident in patients with chronic atrophic CSC. FAG and ICG imaging revealed leakage points in 10 of 43 eyes and choroidal neovascularization (CNV) in 3 of 43 eyes. OCTA imaging confirmed leakage points in 4 out of 10 cases and choroidal neovascularization in 2 out of 3 cases. In one case, OCTA demonstrated a CNV which was not detectable by FAG/ICG. OCTA reveals areas of focal hypo- and hyperperfusion in the choriocapillaris in patients with CSC. Due to the inability to detect plasma flow, OCTA is not suitable to detect leakage points in CSC with confidence. However, OCTA reliably detects CNV in CSC even in the absence of exudative activity and may, therefore, represent an important supplement in the diagnosis of CSC.
中心性浆液性脉络膜视网膜病变(CSC)是一种常见的后天性黄斑病变,其特征是后极部视网膜下液体积聚。本研究旨在分析急性和慢性CSC患者的光学相干断层扫描血管造影(OCTA)结果,并将其与传统成像方法进行比较。本回顾性研究纳入了29例诊断为CSC的患者的43只连续眼睛以及9名健康对照者的18只眼睛。对OCTA图像进行评估,并与传统荧光血管造影(FAG)和吲哚菁绿血管造影(ICG)进行比较。所有CSC患者的脉络膜毛细血管均显示出局部低灌注和高灌注异常区域。这些在慢性萎缩性CSC患者中尤为明显。FAG和ICG成像在43只眼中发现了10处渗漏点,在43只眼中发现了3处脉络膜新生血管(CNV)。OCTA成像在10例中的4例中证实了渗漏点,在3例中的2例中证实了脉络膜新生血管。在1例中,OCTA显示出一处FAG/ICG无法检测到的CNV。OCTA揭示了CSC患者脉络膜毛细血管的局部低灌注和高灌注区域。由于无法检测血浆流动,OCTA无法可靠地检测CSC中的渗漏点。然而,OCTA即使在没有渗出活动的情况下也能可靠地检测CSC中的CNV,因此可能是CSC诊断中的一项重要补充。