Department of Ophthalmology, Military Medical Academy, St Petersburg, Russia.
Smt. Kanuri Santhamma Retina Vitreous Centre, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India.
Br J Ophthalmol. 2018 Sep;102(9):1218-1225. doi: 10.1136/bjophthalmol-2017-311338. Epub 2018 Jan 4.
To identify optical coherence tomography (OCT) findings associated with the leakage points in patients with central serous chorioretinopathy (CSC) to provide fluorescein angiography (FA)-free focal laser photocoagulation (FLP) of the leakage point.
A retrospective study included 48 patients with CSC (48 eyes). Colocalisation of leakage points with pigment epithelial detachments (PEDs) and with areas of photoreceptor outer segments (PROS) layer thinning was evaluated with OCT. Using FA for each leakage point, the relationship to neurosensory detachment was evaluated with retro-mode confocal scanning laser ophthalmoscopy.
Coincidence with PED was found in 52 of 65 (80.0%) leakage points. The PROS thinning was found in 47 of 52 (90.4%) of the PEDs coincided with leakage point. The mean distance from the upper border of neurosensory detachment to the leakage point was 27.3%±13.0% of the vertical dimension of the neurosensory detachment.
This study demonstrates that PEDs localised in the upper half of the neurosensory detachment area and associated with the PROS thinning area coincided with the leakage point in a significant number of patients with CSC. The patients with non-resolving CSC with a small single PED localising in the upper one-third to one-half of the neurosensory detachment area with an area of PROS thinning above this PED may undergo FA-free OCT-guided FLP treating whole PED.
确定与中心性浆液性脉络膜视网膜病变（CSC）患者渗漏点相关的光相干断层扫描（OCT）表现，以便在无需荧光素血管造影（FA）的情况下对渗漏点进行焦点激光光凝（FLP）治疗。
本回顾性研究纳入了 48 例 CSC 患者（48 只眼）。使用 OCT 评估渗漏点与色素上皮脱离（PED）和光感受器外节（PROS）层变薄区的定位关系。对于每个渗漏点，使用 FA 通过 retro-mode 共焦扫描激光检眼镜评估其与神经感觉层脱离的关系。
在 65 个渗漏点中，有 52 个（80.0%）与 PED 重合。在与渗漏点重合的 52 个 PED 中，有 47 个（90.4%）出现 PROS 变薄。神经感觉层脱离的上边界到渗漏点的平均距离为神经感觉层脱离垂直尺寸的 27.3%±13.0%。
本研究表明，在相当数量的 CSC 患者中，PED 位于神经感觉层脱离区域的上半部分，并与 PROS 变薄区域相关，这些区域与渗漏点重合。对于非持续性 CSC 患者，PED 位于神经感觉层脱离区域的上三分之一至一半，且上方有 PROS 变薄区，可进行无需 FA 的 OCT 引导下的 FLP 治疗整个 PED。
