Funatsu Ryoh, Terasaki Hiroto, Mihara Naohisa, Sonoda Shozo, Shiihara Hideki, Miyake Shoki, Imatsuji Hiroki, Sakamoto Taiji
Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan .
Retina. 2025 May 1;45(5):893-900. doi: 10.1097/IAE.0000000000004404.
To identify optical coherence tomography-based imaging biomarkers that can localize focal leakage points without fluorescein angiography in central serous chorioretinopathy (CSC).
This retrospective case-control study analyzed 119 consecutive patients (123 eyes) with CSC between April 2018 and February 2024, comprising 66 eyes with focal-leakage type and 57 eyes with diffuse-leakage type. We assessed leakage sites using optical coherence tomography, and the proportions of optical coherence tomography findings were compared between focal-leakage and diffuse-leakage types.
Hyporeflective lucency signs were observed in 27 eyes (40.9%) with focal-type CSC, while no such signs were detected in diffuse-type CSC cases (0.0%; P < 0.001). In focal-type CSC, these signs were exclusively localized to leakage points, with no occurrence in other areas within serous retinal detachment. Microrips of retinal pigment epithelium and subretinal hyperreflective material were identified in 23 (34.8%) and 47 eyes (71.2%) with focal-type CSC, respectively, and also in eyes with diffuse-type CSC (5.3% and 19.3%, respectively; P < 0.001 for both comparisons).
Only the hyporeflective lucency sign is present exclusively in focal leakage points of fluorescein angiography. Our findings suggested that the hyporeflective lucency sign may serve as a potential therapeutic target in CSC.
识别基于光学相干断层扫描的成像生物标志物,这些标志物可在中心性浆液性脉络膜视网膜病变(CSC)中无需荧光素血管造影即可定位局灶性渗漏点。
这项回顾性病例对照研究分析了2018年4月至2024年2月期间连续的119例CSC患者(123只眼),其中包括66只局灶性渗漏型眼和57只弥漫性渗漏型眼。我们使用光学相干断层扫描评估渗漏部位,并比较局灶性渗漏型和弥漫性渗漏型之间光学相干断层扫描结果的比例。
在27只(40.9%)局灶型CSC眼中观察到低反射透亮征,而在弥漫型CSC病例中未检测到此类征象(0.0%;P<0.001)。在局灶型CSC中,这些征象仅局限于渗漏点,浆液性视网膜脱离的其他区域未出现。视网膜色素上皮微裂孔和视网膜下高反射物质分别在23只(34.8%)和47只(71.2%)局灶型CSC眼中被识别,在弥漫型CSC眼中也有发现(分别为5.3%和19.3%;两项比较P均<0.001)。
只有低反射透亮征仅出现在荧光素血管造影的局灶性渗漏点中。我们的研究结果表明,低反射透亮征可能是CSC的一个潜在治疗靶点。