Okushiba U, Takeda M
Department of Ophthalmology, Sapporo City General Hospital, Hokkaido, Japan.
Nippon Ganka Gakkai Zasshi. 1997 Jan;101(1):74-82.
We performed fluorescein and indocyanine green (ICG) angiographies in 56 patients with central serous chorioretinopathy, and studied the choroidal lesions. In the early phase, choroidal filling with ICG was delayed in 77% in the area including focal leakage. Hypofluorescent findings around the site of focal leakage persisted through the phase in 23%, and we think this finding was caused by filling defect of the choriocapillaris. In the late phase, choroidal tissue staining by ICG was present in 82% in the area including focal leakage. Multiple areas of choroidal staining were also present in unaffected areas in 43% and in 62% of fellow eyes. Choroidal tissue staining by ICG was revealed in 48% in the area of choroidal filling delay, and this finding persisted after focal leakage had disappeared following photocoagulation. We think this finding was caused by choroidal vascular hyperpermeability. These findings suggest that choroidal circulatory disturbance and choroidal vascular hyperpermeability play a causative role in damage to the retinal pigment epithelium in central serous chorioretinopathy.
我们对56例中心性浆液性脉络膜视网膜病变患者进行了荧光素和吲哚菁绿(ICG)血管造影,并研究了脉络膜病变。在早期,包括局灶性渗漏区域在内,77%的患者ICG脉络膜充盈延迟。23%的患者局灶性渗漏部位周围的低荧光表现持续整个阶段,我们认为这一表现是由脉络膜毛细血管充盈缺损所致。在晚期,包括局灶性渗漏区域在内,82%的患者ICG脉络膜组织染色。43%的未受影响区域以及62%的对侧眼也存在多个脉络膜染色区域。在脉络膜充盈延迟区域,48%的患者出现ICG脉络膜组织染色,且在光凝治疗后局灶性渗漏消失后这一表现仍持续存在。我们认为这一表现是由脉络膜血管通透性增加所致。这些发现提示,脉络膜循环障碍和脉络膜血管通透性增加在中心性浆液性脉络膜视网膜病变中视网膜色素上皮损伤过程中起致病作用。