Battista Marco, Borrelli Enrico, Veronese Chiara, Gelormini Francesco, Sacconi Riccardo, Querques Lea, Prascina Francesco, Vella Giovanna, Ciardella Antonio P, Bandello Francesco, Querques Giuseppe
Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Via Olgettina, 58, 20132 Milano, Italy.
Ophthalmology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Via Pelagio Palagi 9, 40138 Bologna, Italy.
J Clin Med. 2020 Jul 16;9(7):2260. doi: 10.3390/jcm9072260.
Central serous chorioretinopathy (CSC) is a complex and not entirely understood retinal disease. The aim of our research was to describe a novel optical coherence tomography (OCT) finding named "choroidal rift", which may be identified in the choroid of eyes with CSC. We collected data from 357 patients (488 eyes) with CSC who had structural OCT and OCT angiography (OCTA) scans obtained. Choroidal rifts were identified as polygonal (and not round-shaped) hyporeflective lesions without hyperreflective margins. Choroidal rifts had to be characterized by a size superior to that of the largest choroidal vessel. Finally, hyporeflective lesions were graded as choroidal rifts only if these lesions had a main development perpendicular to the retinal pigment epithelium. OCT analysis allowed the identification of choroidal rifts in ten eyes from nine patients, all with chronic CSC, with an estimated prevalence rate of 2.1%. In three out of ten cases with choroidal rifts, these lesions spanned all the choroidal layers. In the remaining cases, choroidal rifts only partially spanned the choroidal thickness. In OCTA, choroidal rifts were characterized by the absence of flow. Combining structural OCT and OCTA information, we hypothesized that choroidal rifts may represent interruptions of the choroidal stroma in correspondence of fragile regions (in between expanded larger-sized choroidal vessels). Choroidal rift represents a novel OCT feature, which may characterize eyes with chronic CSC and may have a role in the development of irreversible chorio-retinal changes.
中心性浆液性脉络膜视网膜病变（CSC）是一种复杂且尚未完全被理解的视网膜疾病。我们研究的目的是描述一种名为“脉络膜裂”的新型光学相干断层扫描（OCT）发现，其可能在患有CSC的眼睛脉络膜中被识别。我们收集了357例（488只眼）患有CSC且进行了结构OCT和OCT血管造影（OCTA）扫描的患者的数据。脉络膜裂被识别为多边形（而非圆形）的低反射性病变，且无高反射性边缘。脉络膜裂必须以大于最大脉络膜血管的尺寸为特征。最后，只有当这些低反射性病变的主要发展方向垂直于视网膜色素上皮时，才将其分级为脉络膜裂。OCT分析在9例患者的10只眼中识别出了脉络膜裂，所有患者均患有慢性CSC，估计患病率为2.1%。在10例有脉络膜裂的病例中，有3例这些病变跨越了所有脉络膜层。在其余病例中，脉络膜裂仅部分跨越脉络膜厚度。在OCTA中，脉络膜裂的特征是无血流。结合结构OCT和OCTA信息，我们推测脉络膜裂可能代表在脆弱区域（在扩张的较大尺寸脉络膜血管之间）对应的脉络膜基质中断。脉络膜裂是一种新型的OCT特征，其可能是慢性CSC患者眼睛的特征，并且可能在不可逆的脉络膜视网膜变化的发展中起作用。
