鉴别中心性浆液性脉络膜视网膜病变与新生血管性年龄相关性黄斑变性：一项前瞻性研究。

Distinguishing Central Serous Chorioretinopathy From Neovascular Age-Related Macular Degeneration: A Prospective Study.

作者信息

Grewal Parampal S, Lapere Steven R J, Rudnisky Christopher J, Somani Rizwan, Tennant Matthew T S

机构信息

Department of Ophthalmology, University of Alberta, Edmonton, Alberta, Canada.

出版信息

J Vitreoretin Dis. 2020 Mar 31;4(4):293-299. doi: 10.1177/2474126420914279. eCollection 2020 Jul-Aug.

DOI:10.1177/2474126420914279

PMID:37009176

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9976102/

Abstract

PURPOSE

This article identifies clinical features that differentiate central serous chorioretinopathy (CSR) from neovascular age-related macular degeneration (nAMD) and uses this information to develop a diagnostic tool.

METHODS

A prospective observational study was conducted of patients with a new diagnosis of CSR, nAMD, or indeterminate presentation. All patients underwent clinical assessment, axial length measurement, enhanced-depth imaging-optical coherence tomography, and intravenous fluorescein angiography. A final consensus diagnosis was derived following review of these factors.

RESULTS

A total of 56 eyes of 56 patients were enrolled (CSR = 34; nAMD = 22). The subfoveal choroidal thickness was greater in the CSR group (421 ± 106 µm) than the nAMD group (219 ± 91 µm, < .001). The following odds ratio of CSR reached statistical significance: age 70 and younger (72.00, 95% CI: 11.99-432.50), subfoveal choroidal thickness greater than or equal to 300 µm (33.92, 95% CI: 4.06-283.18), dome-shaped neurosensory detachment (13.24, 95% CI: 3.22-54.45), retinal pigment epithelial changes (0.31, 95% CI: 0.10-0.97), subretinal hyperreflective material (0.11, 95% CI: 0.03-0.42), and fibrovascular pigment epithelial detachment (0.05, 95% CI: 0.01-0.47). A stepwise CSR vs nAMD clinical decision-making algorithm is proposed.

CONCLUSIONS

Choroidal thickness is increased in CSR when compared with nAMD. The presented odds ratios and the CSR vs nAMD clinical decision-making tool can be applied to distinguish CSR from nAMD.

摘要

目的

本文确定了可区分中心性浆液性脉络膜视网膜病变（CSR）与新生血管性年龄相关性黄斑变性（nAMD）的临床特征，并利用这些信息开发一种诊断工具。

方法

对新诊断为CSR、nAMD或表现不明确的患者进行了一项前瞻性观察研究。所有患者均接受了临床评估、眼轴长度测量、增强深度成像光学相干断层扫描和静脉荧光素血管造影。在对这些因素进行评估后得出最终的共识诊断。

结果

共纳入56例患者的56只眼（CSR = 34例；nAMD = 22例）。CSR组的黄斑中心凹下脉络膜厚度（421±106 µm）大于nAMD组（219±91 µm，P <.001）。以下CSR的比值比具有统计学意义：年龄70岁及以下（72.00，95%可信区间：11.99 - 432.50）、黄斑中心凹下脉络膜厚度大于或等于300 µm（33.92，95%可信区间：4.06 - 283.18）、圆顶状神经感觉层脱离（13.24，95%可信区间：）3.22 - 54.45）、视网膜色素上皮改变（0.31，95%可信区间：0.10 - 0.97）、视网膜下高反射物质（0.11，95%可信区间：0.03 - 0.42）和纤维血管性色素上皮脱离（0.05，95%可信区间：0.01 - 0.47）。提出了一种CSR与nAMD的逐步临床决策算法。