摘要
目的观察光学相干断层扫描血管成像(OCTA)在中心性浆液性脉络膜视网膜病变(CSC)患者脉络膜新生血管(CNV)检测中的应用价值。方法回顾性病例观察研究。选取2018年3月至2019年3月在云南省第二人民医院诊断为慢性中心性浆液性脉络膜视网膜病变伴脉络膜新生血管患者30例(34眼)纳入研究,总结分析其OCTA与眼底彩色照相、眼底自发荧光、荧光素眼底血管造影(FFA)和OCT等传统影像学对比运用的临床体会。结果12眼FFA存在荧光素渗漏,但形态模糊,不能确定是否伴有CNV,行OCTA则可以清晰显示新生血管影像。8眼FFA未检出CNV,但OCTA清晰显示出新生血管形态。3眼眼底彩色照相及OCT检查高度怀疑CNV的存在,但因荧光素钠皮试阳性,均无法实施FFA,而OCTA则显示出病变区域血流信号,明确了CNV的存在。6眼FFA无明显荧光素渗漏,OCT示无神经上皮层脱离、无色素上皮层脱离,但OCTA提示CNV的存在。5眼通过随访过程中的病情跟踪观察,发现给予患者单一抗VEGF或PDT治疗之后视网膜下积液无明显吸收,而联合治疗后积液明显吸收。结论OCTA在CNV的检查敏感性方面优于传统的检测手段。OCTA可以作为一项安全有效的眼底影像学检查手段对慢性CSC患者的CNV进行观察,从而指导该类患者的诊断、治疗及预后分析。
Objective To investigate the clinical application of optical coherence tomography angiography(OCTA)in detection of choroidal neovascularization(CNV)in patients with central serous chorioretinopathy(CSC).Methods This retrospective study was conducted on 34 eyes of 30 CSC patients with CSC at the Second People's Hospital of Yunnan Province from March 2018 to March 2019.OCTA results were analyzed and compared with those by fundus color photography,fundus autofluorescence,fluorescence fundus angiography(FFA),OCT and other traditional imaging methods.Results FFA showed fluorescein leakage in 12 eyes,but the morphology was ambiguous;it was not possible to determine whether it was accompanied with CNV.OCTA could clearly show the neovascular image.CNV was not detected in 8 eyes by FFA,but OCTA clearly showed neovascular morphology.Three eyes were highly suspected of CNV by fundus color photography and OCT,but FFA didn’t taken due to the positive fluorescein sodium test;OCTA showed the blood flow signal in the lesion area,confirming the presence of CNV.There was no obvious fluorescein leakage in 6 eyes by FFA,no neuroepithelial detachment or pigment epithelial detachment by OCT;OCTA indicated the presence of CNV.During the follow-up period,there was no obvious absorption of subretinal fluid after single anti-VEGF or PDT treatment,and the effusion was obviously absorbed after combined treatment in 5 eyes.Conclusion OCTA is superior to traditional FFA in the detection sensitivity of CNV.OCTA can be used as a safe and effective fundus imaging method to observe the morphological manifestation of CNV in chronic CSC patients,thus providing references for the diagnosis,treatment and prognosis analysis of CSC.
作者
张娟
黎铧
张利伟
李娟娟
ZHANG Juan;LI Hua;ZHANG Liwei;LI Juanjuan(Department of Ophthalmology,No.2 People’s Hospital of Yunnan Province,the Key Laboratory of Ophthalmology Research of Yunnan Province,Yunnan Eye Hospital,Kunming 650021,Yunnan Province,China)
出处
《眼科新进展》
CAS
北大核心
2020年第5期444-448,共5页
Recent Advances in Ophthalmology
基金
云南省医疗卫生单位内设研究机构科研项目(编号2017NS131)
云南省卫生和计划生育委员会医学后备人才培养计划(编号H-201636)。
