慢性CSC患眼及其对侧眼脉络膜血管指数及中心凹下脉络膜厚度评估

孙功鹏; 易佐慧子; 刘珏君; 陈长征

doi:10.3760/cma.j.cn115989-20200926-00667

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中华实验眼科杂志

• 临床研究 •

ENGLISH ABSTRACT

慢性CSC患眼及其对侧眼脉络膜血管指数及中心凹下脉络膜厚度评估

作者及单位信息

出版日期： 2023 -02 -10 ·

DOI： 10.3760/cma.j.cn115989-20200926-00667

Evaluation of choroidal vascularity index and subfoveal choroidal thickness in eyes with chronic central serous chorioretinopathy and their normal fellow eyes

Authors Info & Affiliations

Sun Gongpeng

Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China

Yi Zuohuizi

Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China

Liu Juejun

Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China

Chen Changzheng

Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China

Published： 2023 -02 -10 ·

DOI： 10.3760/cma.j.cn115989-20200926-00667

APP内阅读

摘要

目的观察慢性中心性浆液性脉络膜视网膜病变(cCSC)脉络膜血管改变，并分析其与中央黄斑厚度(CMT)的相关性。

方法采用横断面研究设计，纳入2018年3月到2019年12月在武汉大学人民医院就诊的单眼cCSC患者38例76眼，并纳入30名年龄、性别、等效球镜度(SE)匹配的正常对照者30人30眼。采用海德堡增强深度成像光学相干断层扫描拍摄所有受检者的脉络膜图像，测量CMT、中心凹下脉络膜厚度(SFCT)、脉络膜血管指数(CVI)、脉络膜总面积(TCA)、脉络膜基质面积(SA)和脉络膜血管腔面积(LA)。比较cCSC患眼、cCSC对侧眼与正常对照眼间SFCT、LA、SA、TCA、CMT和CVI的差异，并分析SFCT与CVI、SFCT与CMT、CVI与CMT之间的相关性。

结果cCSC患眼、cCSC对侧眼与正常对照眼间CVI分别为(71.67±5.60)%、(68.33±3.85)%和(64.70±1.88)%，SFCT分别为483.82(409.01，550.87)、444.66(351.25，505.15)和373.46(327.98，405.48)μm。cCSC患眼CMT、SFCT、TCA、LA、CVI显著高于cCSC对侧眼和正常对照眼，cCSC对侧眼SFCT、TCA、LA、CVI高于正常对照眼，差异均有统计学意义(均P<0.05)。3个组间SA两两比较，差异均无统计学意义(均P>0.05)。相关性分析显示，cCSC患眼SFCT与CVI呈显著正相关(r_s＝0.703，P<0.001)，CMT与SFCT、CVI均无明显相关性(r_s＝0.181，P＝0.278；r＝0.231，P＝0.164)。

结论cCSC患眼及对侧眼SFCT和CVI均较正常人高，cCSC患眼SFCT和CVI稍高于对侧眼，cCSC患者脉络膜血管存在显著扩张。cCSC患眼CMT与SFCT、CVI均无明显相关性。

关键词：中心性浆液性脉络膜视网膜病变;光学相干断层扫描;脉络膜;脉络膜血管指数;中心凹下脉络膜厚度;中央黄斑厚度

ABSTRACT

ObjectiveTo observe the choroidal vascular changes of chronic central serous chorioretinopathy (cCSC), and analyze their correlations with central macular thickness (CMT).

MethodsA cross-sectional study was adopted.Seventy-six eyes of 38 patients with monocular cCSC who were treated in Renmin Hospital of Wuhan University from March 2018 to December 2019 were enrolled, and 30 eyes of 30 normal control matched with age, gender, and spherical equivalent (SE) were included.Choroidal images of all subjects, and the CMT, subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), total choroidal area (TCA), choroidal stromal area (SA), and choroidal luminal area (LA) were measured by Heidelberg enhanced depth imaging optical coherence tomography.The differences in SFCT, LA, SA, TCA, CMT and CVI between the cCSC eye, fellow eye and normal eye, as well as the correlation between SFCT and CVI, SFCT and CMT, and CVI and CMT were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Renmin Hospital of Wuhan University (No.WDRY2020-K234).

ResultsThe CVI and the SFCT of the cCSC eyes, fellow eyes and normal eyes were (71.67±5.60)% and 483.82(409.01, 550.87)μm, (68.33±3.85)% and 444.66(351.25, 505.15)μm, (64.70±1.88)% and 373.46(327.98, 405.48)μm, respectively.The CMT, SFCT, TCA, LA, CVI in cCSC eyes were significantly higher than those in the contralateral eyes and normal control eyes, while SFCT, TCA, LA, CVI in the contralateral eyes were higher than those in normal control eyes (all atP<0.05). Pairwise comparison among the three groups showed no significant difference in SA (all atP>0.05). Correlation analysis showed that in cCSC eyes, SFCT was strongly positively correlated with CVI (r_s=0.703, P<0.001), and there was no correlation between CMT and SFCT (r_s=0.181, P=0.278), or CMT and CVI (r=0.231, P=0.164).

ConclusionsThe SFCT and CVI are higher in cCSC and the fellow eyes compared with normal eyes, and the choroidal vessels are significantly dilated in cCSC patients.The SFCT and CVI of the cCSC eye are slightly higher in comparison with the fellow eye.CMT is not correlated with SFCT or CVI in cCSC eyes.

KEYWORDS： Central serous chorioretinopathy;Tomography, optical coherence;Choroid;Choroidal vascularity index;Subfoveal choroidal thickness;Central macular thickness

Corresponding author: Chen Changzheng, Email: mocdef.3ab61hzhcnehcuhw

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引用本文

孙功鹏,易佐慧子,刘珏君,等. 慢性CSC患眼及其对侧眼脉络膜血管指数及中心凹下脉络膜厚度评估[J]. 中华实验眼科杂志,2023,41(02)：160-165.

DOI:10.3760/cma.j.cn115989-20200926-00667

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中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy，CSC)是一种临床上较常见的导致中年男性中心视力下降的疾病^{[
1
,
2
]}。脉络膜功能障碍是CSC发病的主要机制，CSC患者脉络膜充血、增厚及通透性增加，继发视网膜色素上皮(retinal pigment epithelium，RPE)的结构功能损伤，血－视网膜外屏障破坏，继而诱发视网膜下液(subretinal fluid，SRF)、神经上皮脱离和RPE脱离等^{[
3
,
4
]}。5%~10%的CSC患者存在持续性SRF和RPE改变，从而进展为慢性CSC(chronic CSC，cCSC)^{[
5
]}。增强深度成像光学相干断层扫描(enhanced depth imaging optical coherence tomography，EDI-OCT)的出现使我们能够较为完整、清晰地观察到脉络膜^{[
6
]}。中心凹下脉络膜厚度(subfoveal choroidal thickness，SFCT)和脉络膜血管指数(choroidal vascularity index，CVI)等是可以定量评估脉络膜血管状态的指标^{[
7
,
8
,
9
]}。既往研究多使用SFCT评估CSC患者脉络膜的改变，但SFCT无法分析脉络膜内部结构的改变^{[
10
]}。国内已有研究报道了急性CSC患者SFCT和CVI的改变^{[
11
]}，急性CSC患眼及其对侧眼均存在脉络膜增厚，并伴有脉络膜大血管的显著扩张。但是关于cCSC的研究目前仍存在空白，同时尚无研究对CVI与黄斑厚度的相关性进行分析。本研究拟采用SFCT和CVI定量评估cCSC的脉络膜改变，并分析CVI与中央黄斑厚度(central macular thickness，CMT)的相关性。

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摘要
参考文献

参考文献

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Kaye R ， Chandra S ， Sheth J ，et al. Central serous chorioretinopathy：an update on risk factors，pathophysiology and imaging modalities[J/OL]．Prog Retin Eye Res， 2020，79：100865[2022－07－10]．https://pubmed.ncbi.nlm.nih.gov/32407978/. doi: 10.1016/j.preteyeres.2020.100865 .